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Dai P, Qi L, Jia M, Li T, Ran H, Jiang M, Tang W, Yan C, Yang W, Ren Y, Feng L. Healthcare-seeking behaviours of patients with acute respiratory infection: a cross-sectional survey in a rural area of southwest China. BMJ Open 2024; 14:e077224. [PMID: 38365288 PMCID: PMC10875477 DOI: 10.1136/bmjopen-2023-077224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES This study aimed to assess the healthcare-seeking behaviour and related factors of people with acute respiratory symptoms in the rural areas of central and western China to estimate the disease burden of influenza more accurately. DESIGN Cross-sectional survey. SETTINGS Fifty-two communities/villages in the Wanzhou District, Chongqing, China, a rural area in southwest China, from May 2022 to July 2022. PARTICIPANTS The participants were those who had been living in Wanzhou District continuously for more than 6 months and consented to participate. OUTCOME MEASURES A semistructured questionnaire was used to determine the healthcare-seeking behaviour of participants, and the dichotomous response of 'yes' or 'no' was used to assess whether participants had acute respiratory symptoms and their healthcare-seeking behaviour. RESULTS Only 50.92% (360 of 707) of the patients with acute respiratory infection visited medical and health institutions for treatment, whereas 49.08% (347 of 707) avoided treatment or opted for self-medication. The primary reason for not seeing a doctor was that patients felt their condition was not serious and visiting a medical facility for treatment was unnecessary. Short distance (87.54%) and reasonable charges (49.48%) were ranked as the most important reasons for choosing treatment at primary medical and health facilities (80.27%). The primary reasons for which patients visited secondary and tertiary hospitals (7.78% and 8.61%, respectively) were that doctors in such facilities were better at diagnosis (57.14%) and at treatment (87.10%). CONCLUSION The findings provided in this study indicated that regular healthcare-seeking behaviour investigations should be conducted. The disease burden of influenza can be calculated more accurately when healthcare-seeking behaviour investigations are combined with surveillance in the hospitals.
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Affiliation(s)
- Peixi Dai
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hua Ran
- Wanzhou District Center for Disease Control and Prevention, Wanzhou District, Chongqing, China
| | - Mingyue Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Chaoyang Yan
- Wanzhou District Center for Disease Control and Prevention, Wanzhou District, Chongqing, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuhua Ren
- Wanzhou District Center for Disease Control and Prevention, Wanzhou District, Chongqing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Davies S, Boller E, Chase J, Beaubrun A, Miller C, Jensen I. A cost-consequence analysis of the Xpert Xpress CoV-2/Flu/RSV plus test strategy for the diagnosis of influenza-like illnesses. J Med Econ 2024; 27:430-441. [PMID: 38328858 DOI: 10.1080/13696998.2024.2313391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
AIMS Influenza-like illnesses (ILI) affect millions each year in the United States (US). Determining definitively the cause of symptoms is important for patient management. Xpert Xpress CoV-2/Flu/RSV plus (Xpert Xpress) is a rapid, point-of-care (POC), multiplex real-time polymerase chain reaction (RT-PCR) test intended for the simultaneous qualitative detection and differentiation of SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV). The objective of our analysis was to develop a cost-consequence model (CCM) demonstrating the clinico-economic impacts of implementing PCR testing with Xpert Xpress compared to current testing strategies. METHODS A decision tree model, with a 1-year time horizon, was used to compare testing with Xpert Xpress alone to antigen POC testing and send-out PCR strategies in the US outpatient setting from a payer perspective. A hypothetical cohort of 1,000,000 members was modeled, a portion of whom develop symptomatic ILIs and present to an outpatient care facility. Our main outcome measure is cost per correct treatment course. RESULTS The total cost per correct treatment course was $1,131 for the Xpert Xpress strategy compared with a range of $3,560 to $5,449 in comparators. POC antigen testing strategies cost more, on average, than PCR strategies. LIMITATIONS Simplifying model assumptions were used to allow for modeling ease. In clinical practice, treatment options, costs, and diagnostic test sensitivity and specificity may differ from what is included in the model. Additionally, the most recent incidence and prevalence data was used within the model, which is not reflective of historical averages due to the SARS-CoV-2 pandemic. CONCLUSION The Xpert Xpress CoV-2/Flu/RSV plus test allows for rapid and accurate diagnostic results, leading to reductions in testing costs and downstream healthcare resource utilization compared to other testing strategies. Compared to POC antigen testing strategies, PCR strategies were more efficient due to improved diagnostic accuracy and reduced use of confirmatory testing.
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Affiliation(s)
- Shawn Davies
- PRECISIONheor, Precision Value & Health, Boston, MA, USA
| | - Emily Boller
- PRECISIONheor, Precision Value & Health, Boston, MA, USA
| | | | | | - Cynthia Miller
- PRECISIONheor, Precision Value & Health, Boston, MA, USA
| | - Ivar Jensen
- PRECISIONheor, Precision Value & Health, Boston, MA, USA
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Zhou Y, Li C, Wang W, Ding L. Large-scale data reveal disparate associations between leisure time physical activity patterns and mental health. COMMUNICATIONS MEDICINE 2023; 3:175. [PMID: 38129660 PMCID: PMC10739930 DOI: 10.1038/s43856-023-00399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Leisure time physical activity (LTPA) is known to be associated with a lower risk for mental health burden, while whether the underlying mechanisms vary across populations is unknown. We aimed to explore the disparate associations between LTPA and mental health based on large-scale data. METHODS In this study, we analyzed data including 711,759 individuals aged 15 years or above from the latest four rounds (2003, 2008, 2013, and 2018) of the National Health Service Survey (NHSS) in China. We used multiple logistic regression models adjusted for potential confounders to investigate associations between LTPA and mental health in the total population and subgroups by measuring a diverse set of activity frequencies, intensities, and types. To examine the dose-response associations between total activity volume and mental health, we conducted restricted cubic splines to investigate possible nonlinearity. RESULTS LTPA was associated with remarkably lower self-reported mental health burden (OR 0.56, 95% CI 0.54-0.58). The dose-response relationship between total activity volume and mental health was highly nonlinear (p < 0.001), presenting L-shaped with first 1200 metabolic equivalents of task (METs)-min/week for significant risk reduction (OR 0.58, 95% CI 0.56-0.60). Notably, merely exercising 3-5 times per week with moderate swimming was significantly associated with lower mental health burden among younger people, while the association was strongly large in older adults aged 60 years or above doing 55-min moderate apparatus exercise at least six times a week. CONCLUSIONS In a large Chinese sample, LTPA was meaningfully and disparately associated with mental health burden across different people. Policy targeted at prompting activity may be effective for reducing mental health burden, but importantly, tailored strategies are needed based on population contexts.
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Affiliation(s)
- Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Wei Wang
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
- Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China.
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
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Jia Z, Xue P, Gao R, Wang R, Zhao L, Zuo Z, Gao L, Han R, Yao H, Guo J, Xu J, Zhu Z, Wang J. Epidemiology of Influenza-like Illness and Respiratory Viral Etiology in Adult Patients in Taiyuan City, Shanxi Province, China between 2018 and 2019. Viruses 2023; 15:2176. [PMID: 38005853 PMCID: PMC10674265 DOI: 10.3390/v15112176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
To determine the epidemiological status of influenza and understand the distribution of common respiratory viruses in adult patients with influenza-like illness (ILI) cases in Taiyuan City, Shanxi Province, China, epidemiological data between 2018 and 2019 were retrieved from the China Influenza Surveillance Information System, and two sentinel ILI surveillance hospitals were selected for sample collection. All specimens were screened for influenza virus (IFV) and the other 14 common respiratory viruses using real-time polymerase chain reaction. The results of the 2-year ILI surveillance showed that 26,205 (1.37%) of the 1,907,869 outpatients and emergency patients presented with ILI, with an average annual incidence of 297.75 per 100,000 individuals, and ILI cases were predominant in children <15 years (21,348 patients, 81.47%). Of the 2713 specimens collected from adult patients with ILI, the overall detection rate of respiratory viruses was 20.13%, with IFV being the most frequently detected (11.79%) and at a relatively lower rate than other respiratory viruses. Further subtype analysis indicated an alternating or mixed prevalence of H1N1 (2009), H3N2, Victoria, and Yamagata subtypes. This study provides a baseline epidemiological characterization of ILI and highlights the need for a nationwide detection and surveillance system for multiple respiratory pathogens.
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Affiliation(s)
- Zhao Jia
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Puna Xue
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Ruihong Gao
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Rui Wang
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Lifeng Zhao
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Zhihong Zuo
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Li Gao
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Rui Han
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Hong Yao
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
| | - Jiane Guo
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Jihong Xu
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
| | - Zhen Zhu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jitao Wang
- School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China; (Z.J.); (P.X.); (R.G.); (H.Y.); (J.G.)
- Taiyuan Center for Disease Control and Prevention, No. 22, Huazhang West Street, Xiaodian District, Taiyuan 030032, China; (R.W.); (L.Z.); (Z.Z.); (L.G.); (R.H.); (J.X.)
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Marusca LM, Reddy G, Blaj M, Prathipati R, Rosca O, Bratosin F, Bogdan I, Horhat RM, Tapos GF, Marti DT, Susan M, Pingilati RA, Horhat FG, Adelina M. The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review. Diseases 2023; 11:104. [PMID: 37606475 PMCID: PMC10443358 DOI: 10.3390/diseases11030104] [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: 07/04/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.
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Affiliation(s)
- Larisa Mihaela Marusca
- Laboratory Medicine, “Louis Turcanu” Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania;
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
| | - Gowry Reddy
- New York Medical College at St. Mary’s and St. Clare’s Hospital, Denville, NJ 07834, USA;
| | - Mihaela Blaj
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, 700115 Iasi, Romania
| | | | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Iulia Bogdan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Razvan Mihai Horhat
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Gabriela-Florentina Tapos
- Department of Emergency Medicine, Arad County Emergency Clinical Hospital, Calea Victoriei, 310037 Arad, Romania;
| | - Daniela-Teodora Marti
- Department of Biology and Life Sciences, Faculty of Medicine, “Vasile Goldis” Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania;
| | - Monica Susan
- Department of Internal Medicine, Discipline of Medical Semiology I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India;
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mavrea Adelina
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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Lian XY, Xi L, Zhang ZS, Yang LL, Du J, Cui Y, Li HJ, Zhang WX, Wang C, Liu B, Yang YN, Cui F, Lu QB. Impact of air pollutants on influenza-like illness outpatient visits under COVID-19 pandemic in the subcenter of Beijing, China. J Med Virol 2023; 95:e28514. [PMID: 36661040 DOI: 10.1002/jmv.28514] [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: 10/10/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
This study aimed to explore the association between air pollutants and outpatient visits for influenza-like illnesses (ILI) under the coronavirus disease 2019 (COVID-19) stage in the subcenter of Beijing. The data on ILI in the subcenter of Beijing from January 1, 2018 to December 31, 2020 were obtained from the Beijing Influenza Surveillance Network. A generalized additive Poisson model was applied to examine the associations between the concentrations of air pollutants and daily outpatient visits for ILI when controlling meteorological factors and temporal trend. A total of 171 943 ILI patients were included. In the pre-coronavirus disease 2019 (COVID-19) stage, an increased risk of ILI outpatient visits was associated to a high air quality index (AQI) and the high concentrations of particulate matter less than 2.5 (PM2.5 ), particulate matter 10 (PM10 ), sulphur dioxide (SO2 ), nitrogen dioxide (NO2 ), and carbon monoxide (CO), and a low concentration of ozone (O3 ) on lag0 day and lag1 day, while a higher increased risk of ILI outpatient visits was observed by the air pollutants in the COVID-19 stage on lag0 day. Except for PM10 , the concentrations of other air pollutants on lag1 day were not significantly associated with an increased risk of ILI outpatient visits during the COVID-19 stage. The findings that air pollutants had enhanced immediate effects and diminished lag-effects on the risk of ILI outpatient visits during the COVID-19 pandemic, which is important for the development of public health and environmental governance strategies.
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Affiliation(s)
- Xin Yao Lian
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Lu Xi
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Zhong Song Zhang
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Li Li Yang
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Juan Du
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Yan Cui
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Hong Jun Li
- Beijing Tongzhou Center for Diseases Prevention and Control, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Wan Xue Zhang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Chao Wang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Bei Liu
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Yan Na Yang
- Center for Disease Control and Prevention of Beijing Economic and Technological Development Area, Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing, People's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
| | - Qing Bin Lu
- Department of Laboratorial Science and Technology, Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People's Republic of China
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Minghui Y, Hu Y, Lu Z. How do nurses work in chronic management in the age of artificial intelligence? development and future prospects. Digit Health 2023; 9:20552076231221057. [PMID: 38116395 PMCID: PMC10729617 DOI: 10.1177/20552076231221057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
AI is undeniably revolutionizing medical research and patient care across diverse fields. Chronic disease nursing care, a pivotal aspect of clinical management, has significantly reaped the benefits of AI across numerous dimensions. Understanding the operational principles of artificial intelligence before implementation is crucial, avoiding indiscriminate replacement of all tasks with AI. Nurses serve as the primary force in symptom group research, expanding beyond diabetes to encompass various chronic diseases; their primary responsibility involves recording patients' daily symptoms and vital signs. However, a substantial portion of current AI research excludes nurses from the developmental phase, encompassing them solely in user and feedback populations. The comprehensive design of the symptom analysis and long-term management approach necessitates the guidance and oversight of nurses; however, their current insufficient involvement might stem from nursing staff's comparatively limited comprehension of AI and their ambiguous perception of their role's value in AI. Therefore, an imperative exploration of nurses' roles in symptom analysis and long-term management, leveraging the latest research in these areas, is vital to pinpoint breakthroughs in nurses' AI involvement in the future.
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Affiliation(s)
- Ye Minghui
- First author: Nursing Administration department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yingying Hu
- The First Affiliated Hospital of Wenzhou Medical University, Emergency Department, Wenzhou, Zhejiang, China
| | - Zhongiu Lu
- The First Affiliated Hospital of Wenzhou Medical University, Emergency Department, Wenzhou, Zhejiang, China
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Ge P, Zhang ZW, Zhang JZ, Lyu K, Niu YY, Tong YT, Xiong P, Ling R, Li QY, Yu WL, Min HW, Deng YQ, Wang YJ, Sun XN, Sun XY, Yu L, Wu YB. The self-medication behaviors of residents and the factors related to the consideration of drug efficacy and safety-A cross-sectional study in China. Front Pharmacol 2023; 14:1072917. [PMID: 36925637 PMCID: PMC10011170 DOI: 10.3389/fphar.2023.1072917] [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: 10/18/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Over-the-counter (OTC) drugs facilitates residents self-medication. However, inappropriate self-medications have become a serious problem in China and even all over the world. Objectives: To make an investigation on the current status of Chinese residents' self-medication behaviors and important considerations, and to explore the factors related to the considerations of drug efficacy and safety. Design: A quantitative, cross-sectional study. Methods: Multi-stage sampling was used to conduct a cross-sectional investigation in China 22 provinces, 5 autonomous regions and 4 municipalities directly under the Central Government. State that an interviewer-administrated questionnaire, was used for data collection. The questionnaire that was used in the investigation included demographic sociological characteristics, health literacy scale-short form (HLS-SF), the 10-item Big Five Inventory (BFI-10), the EuroQol-5D visual analogue scale (EQ-5D VAS), self-medication status and important considerations when self-medicating. Descriptive statistics were performed, and the Chi-square test was used for univariate analysis. Log-binomial regression was used for multivariate analysis on whether residents regard drug efficacy or safety as an important consideration. Results: 9256 respondents were included in the data analysis. The self-medication rate of Chinese adults was as high as 99.1%. Paracetamol and other analgesics were the most common types of OTC medication that respondents purchased, followed by vitamins/minerals. Medical staff recommendations, drug safety and efficacy were the top three important considerations. The residents in the east, central and western regions who consider safety is 63.5%, 61.5%, and 66.8% respectively. The proportion of curative effect was 60.2%, 55.7%, and 61.4% respectively. Log-binomial regression showed that western respondents, retired people, those who mainly used ways including basic medical insurance for employees, commercial medical insurance, free medical treatment to cover their medical cost, respondents with high neuroticism, high health literacy were more likely to consider drug safety as an important factor (p < 0.05). Eastern respondents, employed, main way of medical expenses borne was Out-of-pocket Payment, those with chronic disease were more likely to consider drug efficacy as an important factor (p < 0.05). Female, respondents with high levels of agreeableness, conscientiousness, openness, and self-rated health status were more likely to regard both drug safety and efficacy as important considerations (p < 0.05). Conclusion: Self-medication is practiced by most Chinese adults. Whether Chinese adults take drug efficacy or safety as an important consideration is related to their demographic and sociological characteristics, Big Five personality characteristics, health literacy and self-assessed health status. There is a need to strengthen the management of OTC drugs and public education about self-medication.
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Affiliation(s)
- Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Zi-Wei Zhang
- School of Public Health, Peking University, Beijing, China
| | - Jin-Zi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Ke Lyu
- China Medical University, Liaoning, China
| | - Yu-Yao Niu
- Department of English, Faculty of Arts and Humanities, University of Macau, Macao, China
| | - Yu-Ting Tong
- School of Public Health, Shandong University, Jinan, China
| | - Ping Xiong
- Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Rong Ling
- Jilin University School of Pharmaceutical Sciences, Jilin University, Changchun, China
| | - Qi-Yu Li
- School of Humanities and management, Jinzhou Medical University, Jinzhou, China
| | - Wen-Li Yu
- School of Foreign Languages, Weifang University of Science and Technology, Weifang, China
| | - He-Wei Min
- School of Public Health, Peking University, Beijing, China
| | - Yu-Qian Deng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yu-Jia Wang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xiao-Nan Sun
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xin-Ying Sun
- School of Public Health, Peking University, Beijing, China
| | - Lian Yu
- Health Care system Reform and Development Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yi-Bo Wu
- School of Public Health, Peking University, Beijing, China
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9
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Han K, Hou Z, Tu S, Wang Q, Hu S, Xing Y, Du J, Zang S, Chantler T, Larson H. Childhood Influenza Vaccination and Its Determinants during 2020-2021 Flu Seasons in China: A Cross-Sectional Survey. Vaccines (Basel) 2022; 10:vaccines10121994. [PMID: 36560404 PMCID: PMC9783337 DOI: 10.3390/vaccines10121994] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Young children aged 6−59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020−2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77−3.54), safety (OR: 1.60; 95%CI: 1.29−1.99), and effectiveness (OR: 1.54; 95%CI: 1.23−1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00−1.77), family members, or friends (OR: 1.30; 95%CI: 1.14−1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions.
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Affiliation(s)
- Kaiyi Han
- School of Public and Health, Fudan University, Shanghai 200032, China
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Zhiyuan Hou
- School of Public and Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Correspondence:
| | - Shiyi Tu
- School of Public and Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Qian Wang
- School of Public and Health, Fudan University, Shanghai 200032, China
| | - Simeng Hu
- School of Public and Health, Fudan University, Shanghai 200032, China
| | - Yuting Xing
- School of Public and Health, Fudan University, Shanghai 200032, China
| | - Jing Du
- School of Public and Health, Fudan University, Shanghai 200032, China
| | - Shujie Zang
- School of Public and Health, Fudan University, Shanghai 200032, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Department of Health Metrics Sciences, University of Washington, Seattle, WA 98195, USA
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10
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Lai X, Lyu Y, Zhang H, Feng H, Fang H. PPSV-23 recommendation and vaccination coverage in China: a cross-sectional survey among healthcare workers, older adults and chronic disease patients. Expert Rev Vaccines 2022; 21:1343-1353. [PMID: 35924631 DOI: 10.1080/14760584.2022.2110074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND : 23-valent pneumococcal polysaccharide vaccine (PPSV-23) is crucial to protecting high-risk groups. This study aimed to investigate the influencing factors of PPSV-23 recommendation among healthcare workers, and PPSV-23 coverage among Chinese older adults and chronic disease patients. RESEARCH DESIGN AND METHODS : In 2019, a cross-sectional questionnaire survey was conducted in ten provinces in China among older adults aged ≥65 years, chronic disease patients aged 18-64 years, and primary healthcare workers. Multiple logistic regression model was adopted to identify the influencing factors of PPSV-23 recommendation and vaccination uptake. RESULTS : Of the 1138 healthcare workers, 46.75% often recommended PPSV-23 to target groups, and public health workers were more likely to recommend than general practitioners. PPSV-23 vaccination rate was 3.29% among chronic disease patients aged <65 years, 6.69% among older adults without chronic disease(s), and 8.87% among chronic disease patients aged ≥65 years. Multiple logistic regression revealed that only general practitioners' recommendation was associated with increased PPSV-23 coverage (p < 0.05). CONCLUSIONS : The findings highlighted the suboptimal PPSV-23 coverage rate in China and the strong association between healthcare workers' recommendation and residents' vaccination uptake. Targeted and coherent PPSV-23-related training is suggested for general practitioners to encourage effective health promotion in clinical practices.
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Affiliation(s)
- Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Yun Lyu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Haijun Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Huangyufei Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.,Peking University Health Science Center, Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Beijing, China.,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
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11
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Lai X, Li M, Hou Z, Guo J, Zhang H, Wang J, Fang H. Factors associated with caregivers' hesitancy to vaccinate children against influenza: A cross-sectional survey in China. Vaccine 2022; 40:3975-3983. [PMID: 35637066 DOI: 10.1016/j.vaccine.2022.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Seasonal influenza can cause serious harm to children under five years of age, while caregivers are still hesitant to vaccinate children against influenza. This study aimed to investigate caregivers' hesitancy regarding influenza vaccination and assess the associated factors. METHODS From August to October 2019, a cross-sectional survey was conducted in ten provinces in China. The questionnaire collected information about sociodemographic characteristics and caregivers' knowledge, perceptions and attitudes toward influenza vaccination. Caregivers were identified as not hesitating, hesitating or refusing to vaccinate children. Multinomial logistic regression was adopted to determine factors related to vaccine hesitancy based on the 3C model with three dimensions namely complacency, convenience and confidence. RESULTS A total of 6668 valid questionnaires were collected, among which 38.57% did not hesitate to vaccinate children against influenza, 56.03% were hesitant, and 5.40% refused. Multinomial logistic regression showed that caregivers perceiving high importance (AOR = 0.68 for hesitancy; 0.15 for refusal), safety (AOR = 0.42; 0.46) or efficacy (AOR = 0.73; 0.65) of influenza vaccination, knowing children as a priority group (AOR = 0.80; 0.48), and trusting vaccination advice from medical staff (AOR = 0.65; 0.51) had lower odds of hesitancy or refusal. Those considering price as a hindering factor had higher odds of hesitancy (AOR = 1.66) or refusal (AOR = 1.47), and those viewing time or distance as a hindering factor (AOR = 1.45) or having heard of vaccine-related negative information (AOR = 1.78) had higher odds of hesitancy. Sociodemographic characteristics were associated with vaccine hesitancy or refusal, and the associations varied for hesitators and refusers. CONCLUSION A large proportion of caregivers in China reported their hesitancy for influenza vaccination, and the associated factors of such hesitancy were complicated. Health professionals are recommended to spread relevant scientific knowledge and give vaccine-related suggestions to caregivers in doctor visits to promote caregivers' trust in influenza vaccination and therefore expand childhood vaccine coverage.
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Affiliation(s)
- Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
| | - Mengyao Li
- School of Public Health, Peking University, Beijing 100191, China.
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Jia Guo
- School of Public Health, Peking University, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100191, China; Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China; Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100083, China.
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