Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high bur...Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and reproductive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with in-charges of Reproductive and Child Health (RCH) clinics to explore barriers for provision of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underutilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents.展开更多
Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization ...Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients’ records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ<sup>2</sup> = 1.478), gender (χ<sup>2</sup> = 0.224) and dwellings (χ<sup>2</sup> = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ<sup>2</sup> = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ<sup>2</sup> = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.展开更多
Background: As in other developing countries, sexual and reproductive ill-health continues to mostly affect adolescents and youths. Samburu and Turkana counties in Kenya have some of the highest levels of total fertil...Background: As in other developing countries, sexual and reproductive ill-health continues to mostly affect adolescents and youths. Samburu and Turkana counties in Kenya have some of the highest levels of total fertility rates (TFR) at 6.3 and 6.9 respectively placing them well above the national TFR of 3.9. Establishing factors that influence utilization of SRH services among adolescent and youth aged 10 - 24 years is critical in developing an effective program. Method: We used primary data from qualitative and purposeful study design. Data collection used Focus group discussions (FGD), In-depth interviews (IDIs) and Key informant interviews (IDIs). The target groups were adolescents and youth aged 10 - 24 years, health care providers, community health volunteers (CHVs), chemist assistants, parents of adolescents and youth, teachers, spiritual leaders and traditional activists. Findings and Conclusion: Socio-cultural factors were found to influence utilization of SRH services and information. Early marriage, being youth, male only decisions on sexuality matters and fear of family contribute to unprotected sex while myths and misconceptions on contraceptives affected utilization. The findings revealed that youth needs to know sources, how contraceptives work and how to use them. The findings suggest capacity building of health care providers, CHVs, teachers, parents and community leaders on adolescence, sexuality needs of adolescents and disadvantages of female genital mutilation (FGM) including early marriage.展开更多
Introduction: Oral health is window to overall health. There is a greatest burden of oral diseases on the underprivileged group. In developing countries like India the affordability to oral health care services is ve...Introduction: Oral health is window to overall health. There is a greatest burden of oral diseases on the underprivileged group. In developing countries like India the affordability to oral health care services is very limited thereby leading to poor oral wellness & millions suffer intractable toothache and poor quality of living and end up with few dentition. Objective: To assess the utilization level of oral health services among women in Chennai. Material and methods: A cross-sectional questionnaire survey was conducted among 200 women in Teynampet Zone in Chennai District, Tamil Nadu. The women were chosen by simple random sampling and were interviewed using the semi-stzuctured questionnaire to assess their utilization level during the period of June to July 2016. The data were analyzed by SPSS Version 22. Result: Descriptive statistics and multivariate analysis--MANOVA were used to analyze the utilization level. Majority of the respondents were in the age group of 30-35years, most of the respondents had oral problem and almost everyone had visited dentist at least once within 3 years. Multivariate analysis--MANOVA also showed that the utilization levels were directly influenced by accessibility, availability and affordability and showed statistical significance (p value 〈 0.05) and also from MANOVA analysis it showed that the respondents who had poor oral hygiene did not utilize oral health care services as the affordability was a problem although accessibility and availability was adequate. Conclusion: Our fmdings suggest that people who had oral problem had visited dentist in previous 3 years and most of the people who visited dentist had a good oral hygiene. Cost of the treatment affected the dental visits. They believed that visiting the dentist is necessary only for pain relief.展开更多
Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle migh...Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.展开更多
Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 marri...Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.展开更多
Coastal zones are key interconnectors of terrestrial and marine ecosystems.Due to the degradation and fragmentation of coastal wetlands,there is an urgent need to develop assessment methodology to compare the health o...Coastal zones are key interconnectors of terrestrial and marine ecosystems.Due to the degradation and fragmentation of coastal wetlands,there is an urgent need to develop assessment methodology to compare the health of wetland ecosystems at different spatial scales.This will help efficiently develop and implement protections using easy-to-access ecosystem health data.This study aims to understand the spatial distribution of coastal and inland wetland health for China’s coastal regions.A Wetland Health Index(WHI)was developed to provide a basis for policy and decision making.Four utilization models—Long Term Model,Open Model,Nature Reserve Model,and Protected and Economic Model—were defined in the context of China’s coastal regions to specifically examine wetland health.Results show that the average WHI score was 63.6 with the range of 44.8–84.3 for 35 National Nature Reserves(NNRs),and the southern NNRs generally performed better than the northern NNRs.The wetlands in the southern provinces/municipalities are relatively healthier than their northern counterparts.The competent authority has slight influence on WHI scores but duration of conservation establishment does not show a clear correlation.With increasing economic activity,the differences in health conditions(WHI scores)of China’s coastal regions also increase.Gross Domestic Product(GDP)or economic intensification does not relate to WHI scores.Appropriate trade-offs between wetland management and economic development could contribute to improve health conditions,conservation and utilization of coastal and inland wetlands.展开更多
Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services. Method Data were drawn from a baseline questionnaire survey of provision of reproductive health i...Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services. Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002. Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included: counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively, by the society. A. nd they thought the difficulties and obstacles in provision of contraceptive services for un- married youth were in the following order." restriction of the traditional conceptions, shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth. Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China, The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.展开更多
Most young person will become sexually active before their 20<sup>th</sup> birthday having to battle with early and unplanned pregnancies, unsafe abortions, maternal deaths and injuries. This study examine...Most young person will become sexually active before their 20<sup>th</sup> birthday having to battle with early and unplanned pregnancies, unsafe abortions, maternal deaths and injuries. This study examined young person’s sexual knowledge, attitudes and practices and their levels of utilization of sexual reproductive health. Our study progresses beyond current research of reporting only sexual behaviour among youth to have insight into sexual and reproductive health update drivers yielding new empirically robust results for the Ghanaian case for sexual and reproductive health service uptake. The descriptively cross sectional design was employed in sampling 170 youth (150 surveyed and 20 Interviewed) using the stratified sampling technique together with a purposive selection of one key informant. Test of significance and associations were performed with the Chisquare test. In all 45.2% (77/170) of youth (10 - 24) had had sexual experience in life time. In respect of in-school youth, 42% (63/150) had had sexual experience whiles 70% (14/20) out-of-school youth had had sexual intercourse in life time. A total of 28.8% (49/170) of all the youth had sexual intercourse in the last six months with only 40.1 (20/49) using condom for protection. Parental discussion of contraceptive methods (29.3%) and sexual and romantic relationship (28.0%) was the least sexual and reproductive health area discussed among in-school youth. Youth knowledge of the available sexual reproductive health service was statistically associated with reproductive health service utilization (X<sup>2</sup> = 0.00, P ≤ 0.05). A concerted effort is required from government, NGO, Civil society organizations and religious bodies to help translate youth knowledge about sexual health into responsible sexual life and protective sex.展开更多
The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of Natio...The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.展开更多
Existing evidence shows that many Roma communities have received little attention in relation to their health requirements. Evidence illustrates how Roma communities suffer from poorer health and unhealthier living co...Existing evidence shows that many Roma communities have received little attention in relation to their health requirements. Evidence illustrates how Roma communities suffer from poorer health and unhealthier living conditions when compared to majority populations, with their poor health closely linked to wider social determinants. This study explored the health status and associated health needs of the Leeds Roma migrant community, a hard to reach and under-explored group across Europe. Questionnaires (n = 70) and focus groups (n = 43) with Roma community members as well as interviews with health professionals (n = 5) working with them were used. The study found language was a key barrier to accessing health care and understanding health messages. Furthermore, participant’s understandings of the health system were hindered by their different experiences within their countries of origin. Self-reports illustrated low mental well-being, high levels of stress and unhealthy lifestyles as common issues. The research also highlighted several wider determinants of health as key concerns within the Roma community including housing, employment opportunities and money. The findings of this study contribute to increasing understandings of this community’s health needs, their support requirements and the barriers faced by them. These need to be considered to inform strategies and ways of working as mechanisms to tackle health inequalities and promote health within this community.展开更多
Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implement...Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.展开更多
The study aims to examine maternal complications in the eastern states of India. Further, an attempt is also made to understand the socioeconomic factors that determine the utilization of health care services during m...The study aims to examine maternal complications in the eastern states of India. Further, an attempt is also made to understand the socioeconomic factors that determine the utilization of health care services during maternity in the state of West Bengal. The data used for the study are District Level Household Survey (DLHS) 2007-08, which reveals wide regional variations in maternal complications in India. But the state of West Bengal depicts a unique picture. It has the dubious distinction of achieving low fertility and mortality with high maternal complications. The utilisation of health care services in West Bengal was never near completion. Full utilisation of ANC which is essential for safe motherhood is just above national average. A large number of deliveries still take place out of the institution and are unsafe. Analysis reveals that higher age at motherhood increases the probability of utilising maternal health care services. Social groups, years of schooling, wealth index and place of residence also show significant relationship. The findings of the study provide an insight that efforts should be made to create awareness among socially and economically disadvantaged groups of the society about the benefits of utilisation of health care services. Further it also addresses the issue of creating awareness about MDG’s.展开更多
<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all front...<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all fronts and also the population under-information to the health and development problems. Community participation is one of the basic requirements and basic principles of the Primary Health Care to solve this problem. That is why we choose Mosango RHZ to assess the improvement of demand for health services with the involvement of community health workers. <strong>Methods:</strong> We conduct a cross-sectional study carried out in Mosango RHZ in 2019. The study combined a mixed method (quantitative and qualitative) based on the realist evaluation approach which takes into account the Context-Mechanisms-Effects explained in the conceptual framework model. <strong>Results:</strong> Four predictive factors determine the improvement of health indicators with the involvement of CHWS in activities of the Mosango RHZ: Having attended school (p = 0.000;OR = 0.150);Having sufficient theoretical knowledge on malaria, diarrhoea, pneumonia, malnutrition, availability of inputs to treat these diseases (p = 0.004;OR = 0.192);Having taken the training as CHWS and Having undergone more than one training as CHW (p = 0.013;OR = 0.074). This result corroborated with other studies carried in low- and middle-income countries like DRC. <strong>Conclusion:</strong> The involvement of CHWs on improving demand for health services is effective in Mosango RHZ. The improvement of health service indicators and the effectiveness of this community intervention were conditioned by capacity building of the CHWs, the availability of inputs and the involvement of the community in the activities of the health zone through the Community Action Cells.展开更多
Objectives To assess the association of socioeconomic indicators with various chronic and acute illnesses and the utilization of public health care in a new town in Hong Kong, China. Methods Illness experience and soc...Objectives To assess the association of socioeconomic indicators with various chronic and acute illnesses and the utilization of public health care in a new town in Hong Kong, China. Methods Illness experience and socioeconomic and demographic data of 7570 residents from 2022 randomly selected households were collected through telephone interviews. The relationships between socioeconomic indicators and illnesses/choice of health care were explored using stepwise logistic regressions after adjusting for sex and age. Results Significant positive associations were noted between low household income and diabetes mellitus, any chronic illnesses among adults and flu among younger subjects; low educational level and accident-related illness among adults; being born in Chinese mainland and flu, any acute illness in adults. For the utilization of public health care, low household income was the most consistent risk factor. Conclusion This study did not demonstrate a unidirectional socioeconomic gradient in healt展开更多
The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of fam...The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of family health services, we conducted a cross-sectional survey, in the community of Haidian District, Beijing. Chi-square test analysis and multivariate logistic regression models were used to identify factors influencing residents’ demands for family healthcare services. Results show that population of married (OR = 3.108), living with parents (OR = 2.171), degree of Junior high school and above (OR = 7.250) and high school (OR = 7.670), Annual income: 0 - 56,000 (OR = 3.680) and 72,001 - 88,000 (OR = 1.690) have significant demands for family health care. The approach to building primary health services in Haidian District is worth promoting, but it is also important to pay attention to the health inequalities that can occur when patients are moved down to the grassroots level. .展开更多
Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through l...Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.展开更多
Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in...Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.展开更多
Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects shou...Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.展开更多
Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer ser...Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.展开更多
文摘Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and reproductive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with in-charges of Reproductive and Child Health (RCH) clinics to explore barriers for provision of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underutilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents.
文摘Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients’ records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ<sup>2</sup> = 1.478), gender (χ<sup>2</sup> = 0.224) and dwellings (χ<sup>2</sup> = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ<sup>2</sup> = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ<sup>2</sup> = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.
文摘Background: As in other developing countries, sexual and reproductive ill-health continues to mostly affect adolescents and youths. Samburu and Turkana counties in Kenya have some of the highest levels of total fertility rates (TFR) at 6.3 and 6.9 respectively placing them well above the national TFR of 3.9. Establishing factors that influence utilization of SRH services among adolescent and youth aged 10 - 24 years is critical in developing an effective program. Method: We used primary data from qualitative and purposeful study design. Data collection used Focus group discussions (FGD), In-depth interviews (IDIs) and Key informant interviews (IDIs). The target groups were adolescents and youth aged 10 - 24 years, health care providers, community health volunteers (CHVs), chemist assistants, parents of adolescents and youth, teachers, spiritual leaders and traditional activists. Findings and Conclusion: Socio-cultural factors were found to influence utilization of SRH services and information. Early marriage, being youth, male only decisions on sexuality matters and fear of family contribute to unprotected sex while myths and misconceptions on contraceptives affected utilization. The findings revealed that youth needs to know sources, how contraceptives work and how to use them. The findings suggest capacity building of health care providers, CHVs, teachers, parents and community leaders on adolescence, sexuality needs of adolescents and disadvantages of female genital mutilation (FGM) including early marriage.
文摘Introduction: Oral health is window to overall health. There is a greatest burden of oral diseases on the underprivileged group. In developing countries like India the affordability to oral health care services is very limited thereby leading to poor oral wellness & millions suffer intractable toothache and poor quality of living and end up with few dentition. Objective: To assess the utilization level of oral health services among women in Chennai. Material and methods: A cross-sectional questionnaire survey was conducted among 200 women in Teynampet Zone in Chennai District, Tamil Nadu. The women were chosen by simple random sampling and were interviewed using the semi-stzuctured questionnaire to assess their utilization level during the period of June to July 2016. The data were analyzed by SPSS Version 22. Result: Descriptive statistics and multivariate analysis--MANOVA were used to analyze the utilization level. Majority of the respondents were in the age group of 30-35years, most of the respondents had oral problem and almost everyone had visited dentist at least once within 3 years. Multivariate analysis--MANOVA also showed that the utilization levels were directly influenced by accessibility, availability and affordability and showed statistical significance (p value 〈 0.05) and also from MANOVA analysis it showed that the respondents who had poor oral hygiene did not utilize oral health care services as the affordability was a problem although accessibility and availability was adequate. Conclusion: Our fmdings suggest that people who had oral problem had visited dentist in previous 3 years and most of the people who visited dentist had a good oral hygiene. Cost of the treatment affected the dental visits. They believed that visiting the dentist is necessary only for pain relief.
文摘Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.
文摘Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.
基金Under the auspices of National Natural Science Foundation of China(No.41561105)Science and Technology Program of Jiangxi Province,China(No.20151BDH80022)SEE(Society of Entrepreneurs&Ecology)Foundation in the Project of‘Green Book:China’s Coastal Wetlands’。
文摘Coastal zones are key interconnectors of terrestrial and marine ecosystems.Due to the degradation and fragmentation of coastal wetlands,there is an urgent need to develop assessment methodology to compare the health of wetland ecosystems at different spatial scales.This will help efficiently develop and implement protections using easy-to-access ecosystem health data.This study aims to understand the spatial distribution of coastal and inland wetland health for China’s coastal regions.A Wetland Health Index(WHI)was developed to provide a basis for policy and decision making.Four utilization models—Long Term Model,Open Model,Nature Reserve Model,and Protected and Economic Model—were defined in the context of China’s coastal regions to specifically examine wetland health.Results show that the average WHI score was 63.6 with the range of 44.8–84.3 for 35 National Nature Reserves(NNRs),and the southern NNRs generally performed better than the northern NNRs.The wetlands in the southern provinces/municipalities are relatively healthier than their northern counterparts.The competent authority has slight influence on WHI scores but duration of conservation establishment does not show a clear correlation.With increasing economic activity,the differences in health conditions(WHI scores)of China’s coastal regions also increase.Gross Domestic Product(GDP)or economic intensification does not relate to WHI scores.Appropriate trade-offs between wetland management and economic development could contribute to improve health conditions,conservation and utilization of coastal and inland wetlands.
文摘Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services. Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002. Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included: counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively, by the society. A. nd they thought the difficulties and obstacles in provision of contraceptive services for un- married youth were in the following order." restriction of the traditional conceptions, shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth. Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China, The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.
文摘Most young person will become sexually active before their 20<sup>th</sup> birthday having to battle with early and unplanned pregnancies, unsafe abortions, maternal deaths and injuries. This study examined young person’s sexual knowledge, attitudes and practices and their levels of utilization of sexual reproductive health. Our study progresses beyond current research of reporting only sexual behaviour among youth to have insight into sexual and reproductive health update drivers yielding new empirically robust results for the Ghanaian case for sexual and reproductive health service uptake. The descriptively cross sectional design was employed in sampling 170 youth (150 surveyed and 20 Interviewed) using the stratified sampling technique together with a purposive selection of one key informant. Test of significance and associations were performed with the Chisquare test. In all 45.2% (77/170) of youth (10 - 24) had had sexual experience in life time. In respect of in-school youth, 42% (63/150) had had sexual experience whiles 70% (14/20) out-of-school youth had had sexual intercourse in life time. A total of 28.8% (49/170) of all the youth had sexual intercourse in the last six months with only 40.1 (20/49) using condom for protection. Parental discussion of contraceptive methods (29.3%) and sexual and romantic relationship (28.0%) was the least sexual and reproductive health area discussed among in-school youth. Youth knowledge of the available sexual reproductive health service was statistically associated with reproductive health service utilization (X<sup>2</sup> = 0.00, P ≤ 0.05). A concerted effort is required from government, NGO, Civil society organizations and religious bodies to help translate youth knowledge about sexual health into responsible sexual life and protective sex.
基金The Baseline Survey of "The National Urban Community Health Service System Building Project" was funded by Ministry Of Health of China
文摘The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.
文摘Existing evidence shows that many Roma communities have received little attention in relation to their health requirements. Evidence illustrates how Roma communities suffer from poorer health and unhealthier living conditions when compared to majority populations, with their poor health closely linked to wider social determinants. This study explored the health status and associated health needs of the Leeds Roma migrant community, a hard to reach and under-explored group across Europe. Questionnaires (n = 70) and focus groups (n = 43) with Roma community members as well as interviews with health professionals (n = 5) working with them were used. The study found language was a key barrier to accessing health care and understanding health messages. Furthermore, participant’s understandings of the health system were hindered by their different experiences within their countries of origin. Self-reports illustrated low mental well-being, high levels of stress and unhealthy lifestyles as common issues. The research also highlighted several wider determinants of health as key concerns within the Roma community including housing, employment opportunities and money. The findings of this study contribute to increasing understandings of this community’s health needs, their support requirements and the barriers faced by them. These need to be considered to inform strategies and ways of working as mechanisms to tackle health inequalities and promote health within this community.
文摘Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.
文摘The study aims to examine maternal complications in the eastern states of India. Further, an attempt is also made to understand the socioeconomic factors that determine the utilization of health care services during maternity in the state of West Bengal. The data used for the study are District Level Household Survey (DLHS) 2007-08, which reveals wide regional variations in maternal complications in India. But the state of West Bengal depicts a unique picture. It has the dubious distinction of achieving low fertility and mortality with high maternal complications. The utilisation of health care services in West Bengal was never near completion. Full utilisation of ANC which is essential for safe motherhood is just above national average. A large number of deliveries still take place out of the institution and are unsafe. Analysis reveals that higher age at motherhood increases the probability of utilising maternal health care services. Social groups, years of schooling, wealth index and place of residence also show significant relationship. The findings of the study provide an insight that efforts should be made to create awareness among socially and economically disadvantaged groups of the society about the benefits of utilisation of health care services. Further it also addresses the issue of creating awareness about MDG’s.
文摘<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all fronts and also the population under-information to the health and development problems. Community participation is one of the basic requirements and basic principles of the Primary Health Care to solve this problem. That is why we choose Mosango RHZ to assess the improvement of demand for health services with the involvement of community health workers. <strong>Methods:</strong> We conduct a cross-sectional study carried out in Mosango RHZ in 2019. The study combined a mixed method (quantitative and qualitative) based on the realist evaluation approach which takes into account the Context-Mechanisms-Effects explained in the conceptual framework model. <strong>Results:</strong> Four predictive factors determine the improvement of health indicators with the involvement of CHWS in activities of the Mosango RHZ: Having attended school (p = 0.000;OR = 0.150);Having sufficient theoretical knowledge on malaria, diarrhoea, pneumonia, malnutrition, availability of inputs to treat these diseases (p = 0.004;OR = 0.192);Having taken the training as CHWS and Having undergone more than one training as CHW (p = 0.013;OR = 0.074). This result corroborated with other studies carried in low- and middle-income countries like DRC. <strong>Conclusion:</strong> The involvement of CHWs on improving demand for health services is effective in Mosango RHZ. The improvement of health service indicators and the effectiveness of this community intervention were conditioned by capacity building of the CHWs, the availability of inputs and the involvement of the community in the activities of the health zone through the Community Action Cells.
基金This study was support by a grant from the Social Service Committee of the Tai Po District Board.
文摘Objectives To assess the association of socioeconomic indicators with various chronic and acute illnesses and the utilization of public health care in a new town in Hong Kong, China. Methods Illness experience and socioeconomic and demographic data of 7570 residents from 2022 randomly selected households were collected through telephone interviews. The relationships between socioeconomic indicators and illnesses/choice of health care were explored using stepwise logistic regressions after adjusting for sex and age. Results Significant positive associations were noted between low household income and diabetes mellitus, any chronic illnesses among adults and flu among younger subjects; low educational level and accident-related illness among adults; being born in Chinese mainland and flu, any acute illness in adults. For the utilization of public health care, low household income was the most consistent risk factor. Conclusion This study did not demonstrate a unidirectional socioeconomic gradient in healt
文摘The outbreak of Covid-19 affects China’s health delivery system, and the current status of primary health services after the Covid-19 pandemic is not yet clear. To further explore the current status of demands of family health services, we conducted a cross-sectional survey, in the community of Haidian District, Beijing. Chi-square test analysis and multivariate logistic regression models were used to identify factors influencing residents’ demands for family healthcare services. Results show that population of married (OR = 3.108), living with parents (OR = 2.171), degree of Junior high school and above (OR = 7.250) and high school (OR = 7.670), Annual income: 0 - 56,000 (OR = 3.680) and 72,001 - 88,000 (OR = 1.690) have significant demands for family health care. The approach to building primary health services in Haidian District is worth promoting, but it is also important to pay attention to the health inequalities that can occur when patients are moved down to the grassroots level. .
基金This study was supported by the China National Natural Science Foundation of China Youth Science Foundation (71904030)China Medical Board Open Competition Grant (#21-427)+1 种基金Taikang Yicai Public Welfare Foundation (ZXJJ-YCGW-2021009)Fudan Nursing Founding (FNF 202124).
文摘Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.
文摘Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.
文摘Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.
文摘Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.