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Fava GA, Sonino N, Aron DC, Balon R, Berrocal Montiel C, Cao J, Concato J, Eory A, Horwitz RI, Rafanelli C, Schnyder U, Wang H, Wise TN, Wright JH, Zipfel S, Patierno C. Clinical Interviewing: An Essential but Neglected Method of Medicine. Psychother Psychosom 2024; 93:94-99. [PMID: 38382481 DOI: 10.1159/000536490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024]
Abstract
Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to inquire about problems and life setting may actually help to avoid further testing, procedures, and referrals. Moreover, the dialogue between patient and physician is an essential instrument to increase patient's motivation to engage in healthy behavior. The aim of this paper was to provide an overview of clinical interviewing and its optimal use in relation to style, flow and hypothesis testing, clinical domains, modifications according to settings and goals, and teaching. This review points to the primacy of interviewing in the clinical process. The quality of interviewing determines the quality of data that are collected and, eventually, of assessment and treatment. Thus, interviewing deserves more attention in educational training and more space in clinical encounters than it is currently receiving.
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Affiliation(s)
- Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Nicoletta Sonino
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - David C Aron
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Richard Balon
- Departments of Psychiatry and Behavioral Sciences and Anesthesiology, Wayne State University, Detroit, Michigan, USA
| | - Carmen Berrocal Montiel
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Jianxin Cao
- Changzhou First People's Hospital and Psychosomatic Gastroenterology Institute, Soochow University, Changzhou, China
| | - John Concato
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ajandek Eory
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Ralph I Horwitz
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Chiara Rafanelli
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
| | | | - Hongxing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Thomas N Wise
- Department of Psychiatry, Inova Health Systems, Falls Church, Virginia, USA
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Jesse H Wright
- Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tubingen, Tubingen, Germany
- German Centre of Mental Health, Tubingen, Germany
| | - Chiara Patierno
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
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Harris-Lane LM, Storey DP, Drakes DH, Donnan JR, Bishop LD, Harris N. Emerging adult perceptions of cannabis consumption: Examining changes in perceptions from pre-legalization to post-legalization. Int J Drug Policy 2023; 120:104193. [PMID: 37716112 DOI: 10.1016/j.drugpo.2023.104193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Emerging adults (EAs) have the highest rates of cannabis consumption in Canada and are vulnerable to the potential impacts of frequent cannabis consumption. This study assessed EAs' perceived risk of cannabis consumption across multiple domains of potential harm based on the age (14-year-old, 21-year-old, or 28-year-old) and sex (male or female) of the vignette character, time-point (pre- or post-legalization), and participant's gender. METHODS Secondary analyses were conducted on data from a pre-legalization study and post-legalization replication. Participants included EAs between 18 and 25 years of age and living in Newfoundland and Labrador. Participants from the pre- and post-legalization studies were matched based on demographic variables and the assigned vignette character. Participants responded to seven items of perceived risk based on their assigned vignette character's (varied by age or sex) almost daily cannabis consumption. RESULTS Participants (N = 689) viewed cannabis consumption to have greater risks for a 14-year-old compared to a 21- or 28-year-old in all domains except for social life. Prior to legalization, participants who identified as a woman felt that cannabis had more detrimental impacts on social life than participants who identified as a man. Findings also suggested that pre-legalization cannabis consumption by a female was perceived as more detrimental to their social life than pre-legalization consumption by a male and post-legalization consumption by a female. CONCLUSION EAs do not fully appreciate the risks of cannabis consumption, suggesting that it is imperative for public health strategies to promote increased awareness of the risks of frequent cannabis consumption, and improve cannabis health literacy in this population.
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Affiliation(s)
- Laura M Harris-Lane
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - David P Storey
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | - Jennifer R Donnan
- School of Pharmacy, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Lisa D Bishop
- School of Pharmacy, Memorial University of Newfoundland, St. John's, NL, Canada; Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
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Patierno C, Fava GA, Carrozzino D. Illness Denial in Medical Disorders: A Systematic Review. Psychother Psychosom 2023; 92:211-226. [PMID: 37429268 DOI: 10.1159/000531260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment. OBJECTIVE This systematic review was performed to clarify the clinical role and manifestations of illness denial, its impact on health attitudes and behavior, as well as on short- and long-term outcomes in patients with medical disorders. METHODS The systematic search according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was conducted on PubMed, Scopus, and Web of Science. RESULTS The initial search yielded a total of 14,098 articles; 176 studies met the criteria for inclusion. Illness denial appeared to be a relatively common condition affecting a wide spectrum of health attitudes and behavior. In some cases, it may help a person cope with various stages of illness and treatment. In other situations, it may determine delay in seeking treatment, impaired adherence, and reduced self-management, leading to adverse outcomes. The Diagnostic Criteria for Psychosomatic Research (DCPR) were found to set a useful severity threshold for the condition. An important clinical distinction can also be made based on the DCPR for illness denial, which require the assessment of whether the patient has been provided with an adequate appraisal of the medical situation. CONCLUSIONS This systematic review indicates that patients with medical disorders experience and express illness denial in many forms and with varying degrees of severity. The findings suggest the need for a multidimensional assessment and provide challenging insights into the management of medical disorders.
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Affiliation(s)
- Chiara Patierno
- Department of Psychology "Renzo Canestrari," University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Danilo Carrozzino
- Department of Psychology "Renzo Canestrari," University of Bologna, Bologna, Italy
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Abstract
Individual attitudes and behavior related to health and disease are major components of clinical encounters. These factors shape lifestyle, presentation of symptoms, access to patient care, interactions between patients and physicians, adherence to medical advice, and response to treatment. Health attitudes and behavior may range from anxiety and worry about illness to various forms of denial, such as delay of seeking care and lack of adherence to treatment. When attitudes result in health-damaging behavior, they may be particularly difficult to understand and become a source of frustration to both physicians and patients. Devising appropriate responses by health care providers may contribute to improving final outcomes and decrease health care costs. In particular, health behavior is likely to play a major role in the process of convalescence, in self-management of chronic conditions, in determining a state of recovery, and whenever a rehabilitation process is involved. Understanding the spectrum of health attitudes and behavior is also crucial for motivating people to make beneficial changes (lifestyle medicine), as well as for implementing safety procedures in the community.
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Ryszawy J, Kowalik M, Wojnarowicz J, Rempega G, Kępiński M, Burzyński B, Rajwa P, Paradysz A, Bryniarski P. Awareness of testicular cancer among adult Polish men and their tendency for prophylactic self-examination: conclusions from Movember 2020 event. BMC Urol 2022; 22:149. [PMID: 36096827 PMCID: PMC9469579 DOI: 10.1186/s12894-022-01098-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Testicular cancer (TC), due to its non-specific symptoms and occurrence in young men, is particularly dangerous. A critical point for early diagnosis is awareness of the disease and the willingness to perform a testicular self-examination (TSE). The main aim of the study was to assess the knowledge of 771 adult men about testicular cancer. Additionally, the sources of information on TC and TSE were analyzed and the influence of demographic factors on the willingness to join preventative programs was examined. MATERIALS AND METHODS The study was carried out during the Movember2020 campaign, where a testicular ultrasound was performed on participants. They were asked to complete a questionnaire with 26 questions to assess their knowledge. RESULTS The results obtained in the study indicate a low level of knowledge (average 3.5 points out of 18) about TC. Living in a large city (OR = 1.467; p = 0.03), as well as an earlier conversation about TC (OR = 1.639; p = 0.002), increased the awareness about the disease. Additionally it showed that many participants do not perform TSE at all (52.4%) and that only few perform TSE frequently (18.4%). Relationship status (OR = 2.832; p < 0.001) and previous conversations about TC (OR = 1.546; p = 0.02) was reported to be the main contributing factors in males deciding to have TSE. CONCLUSIONS Our research indicates large educational neglect in terms of knowledge about TC and reluctance in performing TSE. It is worth carrying out preventative actions periodically on an increasing scale, not only for the screening of testicular cancer, but also to expand knowledge on this subject.
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Affiliation(s)
- Jakub Ryszawy
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Maksymilian Kowalik
- Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland.
| | - Jakub Wojnarowicz
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Grzegorz Rempega
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Michał Kępiński
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Bartłomiej Burzyński
- grid.411728.90000 0001 2198 0923Department of Rehabilitation, Faculty of Health Sciences, Medical University of Silesia in Katowice, Katowice, Poland
| | - Paweł Rajwa
- grid.22937.3d0000 0000 9259 8492Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Andrzej Paradysz
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Bryniarski
- grid.411728.90000 0001 2198 0923Division of Medical Sciences in Zabrze, Department of Urology, Medical University of Silesia in Katowice, Katowice, Poland
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Mittal R, Loke WM, Seng DOL, Na TM, Yan GLK, Allen PF. Willingness to Pay for Preventive Dental Care Amongst Older Adults. Int Dent J 2021; 72:499-505. [PMID: 34980497 PMCID: PMC9381377 DOI: 10.1016/j.identj.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aims of this study were (1) to investigate willingness to pay (WTP) for preventive and curative dental care procedures and (2) to determine the factors that influence older adults' WTP for dental care. METHODOLOGY Older, independently living adults from Singapore aged 60 years and older and eligible for government-subsidised dental care were nonrandomly recruited for this study. Data were collected using questionnaires and a clinical examination which recorded details of caries experience, number and distribution of posterior occluding contacts, prosthodontic status, and periodontal status. Using a contingent valuation method, participants were asked to rate WTP in Singapore dollars [SGD$] for 4 aspects of care: dental fillings, dental scaling, dental extraction, and disease prevention advice. Negative binomial regression was used to assess the relationship between the predictor variables associated with WTP for dental fillings, scaling, extraction, and preventive advice. RESULTS The mean value of WTP for a dental filling was SGD$30.23 (SGD$31.05), for scaling was SGD$30.28 (SGD$29.46), for dental extraction was SGD$35.08 (SGD$58.54). In a multivariate model, factors associated with higher WTPfees were as follows: (1) dental filling: age (younger), level of education (higher), and frequency of dental visits (regular); (2) scaling: level of education (higher), agree that dental problems affect overall health, and frequency of dental visits (regular); (3) dental extractions: age (younger), level of education (higher), frequency of dental visits (regular), and prosthodontic status (not wearing); (4) preventive advice: age (younger), gender (male), ethnicity (Chinese), level of education (higher), marital status (married), self-perceived oral health (good), and dental visits (regular). CONCLUSIONS The findings of our study suggest that older adults are willing to pay most for extraction and least for preventive advice.
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Affiliation(s)
- Rakhi Mittal
- Faculty of Dentistry, National University of Singapore, Singapore.
| | - Wong Mun Loke
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | - Tan Mei Na
- Faculty of Dentistry, National University of Singapore, Singapore
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Bryden GM, Rockloff M, Browne M, Unsworth C. Effect of contamination and purity priming on attitudes to vaccination and other health interventions: A randomised controlled experiment. Vaccine 2021; 39:6653-6659. [PMID: 34635374 DOI: 10.1016/j.vaccine.2021.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
The objective of this experiment is to assess whether priming for contamination and purity causes a change in attitudes to health interventions, including vaccination, and complementary and alternative medicines (CAMs). An online priming experiment was conducted with four between-subject experimental conditions including photos of: 1) biological contamination, 2) chemical contamination, 3) pure environments, such as pristine landscapes, and 4) hazard signs/icons indicating physical threats. Two control conditions included photos of neutral scenes and neutral icons, whereby experimental groups were compared against the related control groups (photograph for conditions 1-3 and neutral icons for condition 4). Subjects were randomly assigned to one of the six conditions, and after exposure to the images they were asked to rate 10 conventional and alternative health interventions for effectiveness and safety, as well being assessed for disgust sensitivity using the reduced-item DPSS-R [10]. A total of 642 adults completed the experiment. Exposure to primes did not cause a differential change in ratings of health interventions. Nevertheless, higher levels of sensitivity to disgust were associated with lower ratings of the effectiveness of MMR vaccination, tetanus injection, antibiotics, and surgery; and higher levels of sensitivity to disgust were associated with higher ratings of effectiveness of vitamins/minerals. In conclusion, this online experiment did not find an experimental effect of priming for contamination and purity on subjects' ratings of the safety and effectiveness of conventional and alternative health interventions. This indicates that attitudes to these health interventions are not influenced by a temporary increase in the salience of feelings of contamination or purity. However, individual differences in disgust sensitivity are related to their attitudes to vaccination and CAM interventions.
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Affiliation(s)
- Gabrielle M Bryden
- School of Human, Health & Social Sciences, Central Queensland University, University Dr, Branyan, QLD 4670, Australia
| | - Matthew Rockloff
- School of Human, Health & Social Sciences, Central Queensland University, University Dr, Branyan, QLD 4670, Australia
| | - Matthew Browne
- School of Human, Health & Social Sciences, Central Queensland University, University Dr, Branyan, QLD 4670, Australia.
| | - Carolyn Unsworth
- School of Health, Federation University Australia, Gippsland Campus, Northways Road, Churchill, Victoria 3842 Australia
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Chittamuru D, Daniels R, Sarkar U, Schillinger D. Evaluating values-based message frames for type 2 diabetes prevention among Facebook audiences: Divergent values or common ground? Patient Educ Couns 2020; 103:S0738-3991(20)30473-0. [PMID: 32938563 PMCID: PMC8213394 DOI: 10.1016/j.pec.2020.08.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 08/07/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To effectively confront the type 2 diabetes (T2D) epidemic, policymakers and the public need to problematize T2D less as a medical and more as a social problem. An award-winning T2D prevention campaign was harnessed to determine the most successful ways of framing ads on Facebook. HYPOTHESIS We will observe variation in the effectiveness of ad message-frames within audience-segments. METHODS Six parallel quasi-experiments (participants N = 203,156) were conducted with 6 disparate audience-segments defined through the Facebook ads-manager tool. Across all audiences, we exposed Facebook users to values-based ad-frames (10-15-word appeals), assigning 7 of 11 possible frames to participants within each audience in a quasi-experimental fashion (using Facebook users' birth-month). Engagement was measured by rates of ad video-views, unique-link-clicks and donations to the campaign. RESULTS Contrary to our hypothesis, we observed remarkable consistency across target audiences. Ad-frames that ranked highly with most audience-segments included Entertainment and Emotional Appeal; Defiance Against Authority Appeal; Second-Hand Smoke/Environmental Appeal; and to a lesser extent, Common-Enemy/War-Metaphor Appeal. Conclusion and Practice-Implications: Across disparate segments of society, there appears to be a set of common values that public health communication initiatives can tap into to catalyze a more inclusive movement to confront the T2D epidemic through policy, systems and environmental approaches.
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Affiliation(s)
- Deepti Chittamuru
- Public Health Department, School of Social Sciences, Humanities and Art, University of California Merced, 5200 N. Lake Rd, Merced, CA 95343 USA.
| | - Ryane Daniels
- Division of General Internal Medicine and Health Communications Research Program, Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Ave, SFGH 10, 1320A, San Francisco, CA 94110 USA.
| | - Urmimala Sarkar
- Division of General Internal Medicine and Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Ave, 1319, San Francisco, CA, 94110 USA.
| | - Dean Schillinger
- Division of General Internal Medicine and Health Communications Research Program, Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Ave, SFGH 10, 1320A, San Francisco, CA 94110 USA.
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von Linstow ML, Nordmann Winther T, Eltvedt A, Bybeck Nielsen A, Yde Nielsen A, Poulsen A. Self-reported immunity and opinions on vaccination of hospital personnel among paediatric healthcare workers in Denmark. Vaccine 2020; 38:6570-6577. [PMID: 32800467 PMCID: PMC7424471 DOI: 10.1016/j.vaccine.2020.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 11/05/2022]
Abstract
Vaccination of healthcare workers prevents the spread of infections in hospitals. A forth of healthcare workers reported to be non-immune to vaccine-preventable diseases. Nine out of 10 employees supported vaccination of non-immune healthcare workers. National recommendations for vaccination of healthcare workers in Denmark are needed.
Background Denmark has no general recommendations for vaccination of healthcare workers (HCWs). We explored the self-reported immunity to varicella, measles, mumps, and rubella, reasons for receiving the influenza vaccine or not, and opinions on vaccination of HCWs against varicella, MMR, pertussis, diphtheria, and influenza among staff from departments with a high risk of exposure to infectious agents. Methods From May 2019 to August 2019, a structured questionnaire was distributed to clinical and non-clinical HCWs at a tertiary and a general paediatric department in Denmark. Self-reported immunity was defined as either previous infection or vaccination against the disease. Results Of 619 employed HCWs, 555 (90%) were included. A large proportion were unsure of or denied previous vaccination or infection with measles (20.1%), mumps (30.2%), rubella (21.4%), varicella (12.1%), pertussis (44.1%), and diphtheria (32.1%). Non-clinical personnel and employees born in 1974–1983 had the lowest level of self-reported immunity. Mandatory vaccination of non-immune HCWs was approved by 54–68.9% of participants, and any kind of vaccination (mandatory or as an offer at hospitals) was approved of up to 95.3% of all participants depending on the disease. During the season 2018/19, 214 (38.6%) HCWs received the influenza vaccine, including 20.3% of non-clinical staff, 34.8% of nurses and 56.5% of doctors (P < 0.001). Reasons for lack of vaccine uptake were mainly employees considering themselves rarely sick, the vaccine was not regarded as necessary, forgetfulness or lack of time. Only 37.8% was in favour of mandatory influenza vaccination. Conclusions A large proportion of paediatric HCWs were not aware of their immune status against important vaccine-preventable diseases. >90% supported vaccination of HCWs, with two out of three supporting mandatory MMR, pertussis and diphtheria vaccination. Better information and an official immunisation policy of non-immune HCWs in Denmark is warranted.
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Affiliation(s)
- Marie-Louise von Linstow
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Thilde Nordmann Winther
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
| | - Anna Eltvedt
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark.
| | - Allan Bybeck Nielsen
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
| | - Alex Yde Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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Xie Z, Liu K, Or C, Chen J, Yan M, Wang H. An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health 2020; 20:1227. [PMID: 32787809 PMCID: PMC7424981 DOI: 10.1186/s12889-020-09274-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. METHODS We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. RESULTS Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. CONCLUSIONS Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients' self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient-physician interactions.
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Affiliation(s)
- Zhenzhen Xie
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Kaifeng Liu
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Calvin Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China.
| | - Jiayin Chen
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Mian Yan
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai, China
| | - Hailiang Wang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
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Park J, Kim SH, Kim JG. Effects of message framing and health literacy on intention to perform diabetes self-care: A randomized controlled trial. Diabetes Res Clin Pract 2020; 161:108043. [PMID: 32006642 DOI: 10.1016/j.diabres.2020.108043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/17/2019] [Accepted: 01/27/2020] [Indexed: 12/31/2022]
Abstract
AIMS To evaluate the effect of positive and negative message framing in diabetes education on attitudes, perceived control, and behavioral intentions toward diabetes self-care, and to identify potential moderating effects of health literacy on message framing. METHODS A total of 52 patients with type 2 diabetes that visited an ambulatory endocrinology wing at a university hospital in Korea were randomized into positive or negative message framing groups. Each group watched a 10-minute video that was either positively or negatively framed, accentuating desirable outcomes from good diabetes self-care in the former and undesirable outcomes from inadequate diabetes self-care in the latter. Two-way ANCOVA controlling for HbA1C was conducted to evaluate outcomes. RESULTS Patients who watched the negatively framed message showed significantly more favorable attitudes and perceived control toward diabetes self-care than those who viewed the positively framed message. Message framing had significant indirect effects on behavioral intentions for diabetes self-care that were mediated by attitudes and perceived control. Conversely, no significant interaction effects were observed between health literacy level and message framing of these same markers. CONCLUSION The use of negative message framing in diabetes education is a promising strategy for shaping favorable attitudes, beliefs, and intentions toward diabetes self-care behavior.
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Affiliation(s)
- Jihyun Park
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Su Hyun Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
| | - Jung Guk Kim
- Department of Endocrinology, Kyungpook National University Medical Center, Daegu, South Korea
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12
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González Peredo R, Prieto Salceda MDLD, Incera Alvear IM, Fernández Díaz F, Campos Caubet L, Crespo Hualde E, García-Lago Sierra Á, Ortiz Oficialdegui P. [Treatment adherence in a hospital emergency service]. Rev Esp Salud Publica 2019; 93:e201910086. [PMID: 31641097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 08/14/2019] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE Patients do not always follow medical indications. This is a public health problem, with implications in health care and costs. The objective of this study was to calculate the percentage of non-adherence of adults to the treatment prescribed in a Hospital Emergency Service ("HES") and understanding wich factors led to poor adherence so improvements can be established. METHODS Prospective observational study. Cohort of adults who attended the HES. We collected sociodemographic data, medical history, chronic treatments, diagnosis and treatment at discharge from each individual. We applied Morisky-Green test (tailor made to the HES) to asses secondary non-adherence and multivariate analysis to find a correlation with the factors studied. RESULTS We established a non-adherence of 36.6% (IC95%=30.0-43.8). Patients with chronic endocrine pathology (RR=11.2; IC95%=2.1-60.8), diagnosed with ophthalmological problems (RR=9.8; IC95%=1.1-89.6) or contusions, sprains or fractures (RR=2.9; IC95%=1.1- 7.8), those who were prescribed antibiotics (RR=5.4; IC95%=2.4-11.9), or those who considered that they had received sufficient explanations (RR=3.5; IC95%=1.0-13.2) were more adherent. Those who received analgesics or anti-inflammatories were less adherent (RR=0.4; IC95%=0.2-0.9). CONCLUSIONS Our results provide information on adherence in acute pathologies in the emergency department. Diabetes and ophthalmological problems or trauma are predictors of increased adherence. We observe more adherence in people with antibiotic treatments, although 20% did not complete treatment. There is a lack of adherence to analgesic/anti-inflammatory treatments. We consider it is important for professionals to take into account patient´s concerns about the medication. Patients who considered they had received enough explanations on their treatment were more adherent tan others. We believe it would be useful to provide further information about the outcomes of the medication we prescribe using new technologies such as mobile applications so we could increase adherence. Further studies would be needed to asses the benefit of the changes recently introduced (electronic hisory and prescription).
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Affiliation(s)
- Rebeca González Peredo
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - María de Los Dolores Prieto Salceda
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Isabel María Incera Alvear
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Fernando Fernández Díaz
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Luis Campos Caubet
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Esther Crespo Hualde
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Ángel García-Lago Sierra
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
| | - Pilar Ortiz Oficialdegui
- Hospital Sierrallana (Cantabria). Servicios de Urgencias y Cardiología. Observatorio de Salud Pública de Cantabria (OSPC). Grupo de Investigación de Epidemiología, Salud Pública y Urgencias. Torrelavega. España
- Institut d'Investigació Sanitària Pere Virgili. Reus. España
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13
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McCoy JD, Painter JE, Jacobsen KH. Perceptions of vaccination within a Christian homeschooling community in Pennsylvania. Vaccine 2018; 37:5770-5776. [PMID: 30253888 DOI: 10.1016/j.vaccine.2018.09.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND More than 1.8 million American children ages 5-17 are being educated at home. The percentage of school-aged children in the United States who are homeschooled increased from 1.7% in 1999 to 3.4% in 2012. Every state has established school-entry vaccination requirements for kindergarten students, but most states exempt homeschoolers from these regulations. The goal of this study was to use qualitative methods to examine the vaccination perceptions and practices of Christian homeschooling families in Pennsylvania. METHODS A qualitative study (focus groups) of Christian homeschooling parents representing a diversity of vaccination practices (full, partial/delayed, and no vaccination) was conducted in south-central Pennsylvania in 2017. An analysis using a grounded theory approach identified themes that strongly aligned with constructs from the Health Belief Model. RESULTS Many of the perspectives expressed by the study population aligned with those of the general American population, including uncertainty about the risk from vaccine-preventable diseases, concerns about the efficacy and safety of vaccines, and confusion about conflicting vaccine information. The Christian homeschooling parents expressed two especially prominent perceptions: a belief that they had a very low risk of contracting infectious diseases because God has provided them with the natural tools necessary for health and a stronger-than-typical sense of empowerment related to parental decision-making and autonomy. Participants expressed that they were generally open to honest communication about vaccination with physicians who respect parental authority. CONCLUSIONS Homeschooling families have diverse vaccination practices. Pediatricians and other healthcare practitioners should not make assumptions about health beliefs in this community, and should instead engage parents in conversations about their risk perceptions and vaccine decisions.
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Affiliation(s)
- Jeremiah D McCoy
- Department of Global & Community Health, George Mason University, Fairfax, VA, USA
| | - Julia E Painter
- Department of Global & Community Health, George Mason University, Fairfax, VA, USA
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, Fairfax, VA, USA.
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14
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Lee YH, Lu CW, Wu PZ, Huang HL, Wu YC, Huang KC. Attitudes and awareness of medical assistance while traveling abroad. Global Health 2018; 14:67. [PMID: 29996856 PMCID: PMC6042459 DOI: 10.1186/s12992-018-0382-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With globalization, more and more people travel to countries where they are at risk of injuries and travel-related diseases. To protect travelers' health, it is crucial to understand whether travelers accurately perceive medical assistance resources before and during their trips. This study investigated the need, awareness, and previous usage of overseas emergency medical assistance services (EMAS) among people traveling abroad. METHODS Anonymous questionnaires were distributed to patients (n = 500) at a travel clinic in Taipei, Taiwan. RESULTS The results showed that EMAS were important, especially in the following categories: 24-h telephone medical consultation (91.8%), emergent medical repatriation (87.6%), and assistance with arranging hospital admission (87.4%). Patients were less aware of the following services: arrangement of appointments with doctors (70.7%) and monitoring of medical conditions during hospitalization (73.0%). Less than 5% of respondents had a previous experience with EMAS. CONCLUSIONS EMAS are considered important to people who are traveling abroad. However, approximately 20-30% of travelers lack an awareness of EMAS, and the percentage of travelers who have previously received medical assistance through these services is extremely low. The discrepancy between the need and usage of EMAS emphasizes the necessity to adapt EMAS materials in pre-travel consultations to meet the needs of international travelers.
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Affiliation(s)
- Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Pei-Zu Wu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, Taipei City Hospital Heping Fuyou Branch, No.33, Sec. 2, Zhonghua Rd., Wanhua District, Taipei, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Yi-Chun Wu
- Centers for Disease Control, No.6, Linsen S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan. .,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan. .,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.
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15
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Pickard AS, Jalundhwala YJ, Bewsher H, Sharp LK, Walton SM, Schumock GT, Caskey RN. Lifestyle-related attitudes: do they explain self-rated health and life-satisfaction? Qual Life Res 2018; 27:1227-1235. [PMID: 29302851 DOI: 10.1007/s11136-017-1774-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Strategies to improve public health may benefit from targeting specific lifestyles associated with poor health behaviors and outcomes. The aim of this study was to characterize and examine the relationship between health and lifestyle-related attitudes (HLAs) and self-rated health and life-satisfaction. METHODS Secondary analyses were conducted on data from a 2012 community wellness survey in Kirklees, UK. Using a validated HLA tool, respondents (n = 9130) were categorized into five segments: health conscious realists (33%), balanced compensators (14%), live-for-todays (18%), hedonistic immortals (10%), and unconfident fatalists (25%). Multivariate regression was used to examine whether HLAs could explain self-rated health using the EQ-5D visual analog scale (EQ-VAS) and life-satisfaction. Health conscious realists served as the reference group. RESULTS Self-rated health differed by HLA, with adjusted mean EQ-VAS scores being significantly higher (better) among balanced compensators (1.15, 95% CI 0.27, 2.03) and lower scores among unconfident fatalists (- 9.02, 95% CI - 9.85, - 8.21) and live-for-todays (- 1.96, 95% CI - 2.80, - 1.14). Balanced compensators were less likely to report low life-satisfaction (OR 0.75, 95% CI 0.62, 0.90), while unconfident fatalists were most likely to have low life-satisfaction (OR 3.51, 95% CI 2.92, 4.23). SIGNIFICANCE Segmentation by HLA explained differences in self-rated health and life-satisfaction, with unconfident fatalists being a distinct segment with significantly worse health perceptions and life-satisfaction. Health promotion efforts may benefit from considering the HLA segment that predominates a patient group, especially unconfident fatalists.
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Affiliation(s)
- A Simon Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA. .,Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA.
| | - Yash J Jalundhwala
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA
| | - Helen Bewsher
- Kirklees Council, The University of Manchester, Huddersfield, West Yorkshire, United Kingdom
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA.,Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA
| | - Surrey M Walton
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA.,Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA
| | - Glen T Schumock
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA.,Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, 833 S Wood St, Chicago, IL, 60612, USA
| | - Rachel N Caskey
- Internal Medicine and Pediatrics, College of Medicine, University of Illinois at Chicago, 840 S Wood St, Chicago, IL, 60612, USA
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16
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Abstract
OBJECTIVE Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19. MATERIALS AND METHODS A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo. RESULTS The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2 ± 1.5), than among subjects, age 15 (3.6 ± 1.2) (p = .0009), and subjects, age 19 (3.5 ± 1.2) (p = .00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p = .002 and .001, respectively) and (ii) previous orthodontic treatment (p = .005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p = .002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p = .047) than Swedes, age 19. CONCLUSIONS The lower limit for orthodontic treatment need among subjects, age 10, was higher - compared to subjects, ages 15 and 19 - and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.
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Affiliation(s)
| | - Rune Lindsten
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Mats Bågesund
- Center for Orthodontics and Pediatric Dentistry, Public Dental Service, Östergötland, Sweden
- Department of Clinical and Experimental Medicine, Faculty of Medical and Health Sciences, Linköping University, Linköping, Sweden
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17
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O'Leary K, Eschler J, Kendall L, Vizer LM, Ralston JD, Pratt W. Understanding Design Tradeoffs for Health Technologies: A Mixed-Methods Approach. Proc SIGCHI Conf Hum Factor Comput Syst 2015; 2015:4151-4160. [PMID: 28804794 DOI: 10.1145/2702123.2702576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We introduce a mixed-methods approach for determining how people weigh tradeoffs in values related to health and technologies for health self-management. Our approach combines interviews with Q-methodology, a method from psychology uniquely suited to quantifying opinions. We derive the framework for structured data collection and analysis for the Q-methodology from theories of self-management of chronic illness and technology adoption. To illustrate the power of this new approach, we used it in a field study of nine older adults with type 2 diabetes, and nine mothers of children with asthma. Our mixed-methods approach provides three key advantages for health design science in HCI: (1) it provides a structured health sciences theoretical framework to guide data collection and analysis; (2) it enhances the coding of unstructured data with statistical patterns of polarizing and consensus views; and (3) it empowers participants to actively weigh competing values that are most personally significant to them.
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Affiliation(s)
| | | | - Logan Kendall
- Biomedical and Health Informatics, University of Washington
- DUB Group Seattle, WA 98195 USA
| | - Lisa M Vizer
- Biomedical and Health Informatics, University of Washington
- DUB Group Seattle, WA 98195 USA
| | | | - Wanda Pratt
- The Information School, Seattle, WA 98195 USA
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18
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Robertson DW, Lang BD, Schaefer JM. Parental attitudes and behaviours concerning helmet use in childhood activities: rural focus group interviews. Accid Anal Prev 2014; 70:314-319. [PMID: 24836477 DOI: 10.1016/j.aap.2014.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 03/14/2014] [Accepted: 04/19/2014] [Indexed: 06/03/2023]
Abstract
Previous research demonstrates the importance of parents in ensuring that their children practice proper helmet use. Parents encourage helmet use by setting an example when they wear helmets, as well as establishing rules that the children are expected to follow. Research in the area of helmet use predominantly focuses on bicycle helmets, but there are a number of childhood activities for which a helmet is required. The purpose of this research was to examine rural parents' attitudes toward helmet use and investigate when, and for what activities, they require their children to wear helmets. Rural parents were selected as there is evidence that helmet use is less frequent among children in rural settings. Expanding on the literature, an exploratory qualitative methodology was used to gather data. Eight focus groups were held in rural Saskatchewan to explore what influences parents' decisions to wear helmets themselves, and when and why they enforce helmet rules with their children. A thematic analysis was subsequently conducted on the data. The results suggest that parents recognize that their rules and their example influence their children. Participants mentioned being consistent, establishing rules and using positive reinforcement as ways to encourage helmet use among their children. Helmet costs and lack of awareness of helmet necessity in particular activities were barriers to helmet use. Specific barriers to helmet use in rural areas included the difficulty in finding proper helmets, the lack of exposure to helmet promotion initiatives, and the perception that activities in rural areas were safer than in the city. Parents tended to make their own helmet decisions based on personal experience and threat perception of the activity. This reasoning was the basis for when and why they established helmet rules. It is important to raise awareness of the risks of head injury and the benefits of wearing a helmet in other activities besides bicycling. More effort is needed to reach rural populations with information and opportunities to access appropriate and affordable helmets. Legislating mandatory helmet use could be useful in promoting helmet use in adults and children. Alternatively, the use of incentives for children wearing helmets could also serve as a reinforcement mechanism to increase use. A synthesis of the data gathered suggests that a theoretical approach based on increasing predisposing, enabling and reinforcing factors for helmet use may be useful in future interventions.
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Affiliation(s)
- Daniel W Robertson
- The Saskatchewan Prevention Institute, 1319 Colony St., Saskatoon, SK S7N 2Z1, Canada.
| | - Brittany D Lang
- The Saskatchewan Prevention Institute, 1319 Colony St., Saskatoon, SK S7N 2Z1, Canada.
| | - Joelle M Schaefer
- The Saskatchewan Prevention Institute, 1319 Colony St., Saskatoon, SK S7N 2Z1, Canada.
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Gust DA, Shinde S, Pals SL, Hardnett F, Chen RT, Sanchez T. Correlates of health attitudes among homosexual and bisexual men. J Epidemiol Glob Health 2013; 3:31-9. [PMID: 23856536 PMCID: PMC7320376 DOI: 10.1016/j.jegh.2012.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 10/19/2012] [Accepted: 12/18/2012] [Indexed: 11/30/2022] Open
Abstract
There is increased emphasis on physician attention to the overall health and wellness of homosexual and bisexual men, though little is known about the health-related attitudes of these groups. This study determined factors associated with the health attitudes of homosexual and bisexual men and identified preferred sources of health information. For this study, the 2008 ConsumerStyles panel survey was used to create three health attitude scales and to determine factors associated with each scale. The three scales were labeled: (1) health motivation; (2) relationship with health care provider; and (3) self-perception of health literacy. In addition to other factors, higher scores for health motivation and relationship with health care provider were associated with black compared with white men. In contrast, lower scores for self-perception of health literacy were associated with black compared with white men. For information on an unfamiliar health condition, most homosexual and bisexual men chose the Internet. Black homosexual and bisexual men reported being motivated to be healthy and working well with their health care provider to manage their health. However, their perception of their own health motivation was low compared with the white men. Attempts to improve health literacy through Internet sites may be helpful in improving health attitudes and reducing negative health outcomes.
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Affiliation(s)
- Deborah A Gust
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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