Self-care practices and health-seeking behavior among older persons in a developing country:Theories-based research

Purpose:The aim of this study was to examine the self-care practices and health-seeking behaviours of older adults in urban Indonesia.Methods:The cross-sectional study was performed from January to March 2014 in the Tammua sub-district of Indonesia.At the time of the study,273 older adults resided in Tammua,and half of them(51.2%)participated in this study.Data collection was carried out including self-care practices,health literacy,self-efficacy and basic conditioning factors.Results:It was found that most respondents(124;88.6%)always ate various protein sources daily.However,many participants never limited consumption of sugar(55;39.3%)or salt(40;28.6%),and more than half of respondents(96;68.6%)did not regularly visit MHCs.Health status(p<0.05),health maintenance(p<0.01)and salt limitation(p<0.05)were all significantly associated with salt limitation.It was found that respondents with higher selfefficacy,those who did not want to get information,and those of younger ages are less likely to visit MHCs regularly.Conclusion:An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries.High self-efficacy should be promoted along with adequate health literacy.Older persons should learn the importance of regular health examinations to promote health,prevent diseases,and slow the progress of chronic diseases.The number of respondents who never limit their sugar and salt intake was especially surprising.An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.

Effect of HbA_(1c) combined FPG on screening diabetes in health checkup

Objective:To appraise the effectiveness of HbA_(1c) and fasting plasma glucose(FPG) on screening diabetes in health check-up.Methods:A total of 1 337 individuals(male 850,female 487),aged 27 to 91 years with HbA_(1c) test were included.Participates with HbA_(1c)≥6.0%or FPG≥6.1 mmol/ L underwent oral glucose tolerance test(OGTT).Diabetes mellitus was diagnosed according to the criteria of WHO in 1999,FPG≥7.0 mmol/L and/or OGTT 2 h-postload plasm glucose(2 h-PG)≥11.1 mmol/L.The sensitivity and specificity of HbA_(1c) thresholds and FPG or combination test on screening of diabetes were analyzed.Results:A total of 842 subjects had HbA_(1c)<6.0%,in which 32 had isolated FPG≥6.1 mmol/L,of 495 had HbA_(1c)≥6.0%.Subjects with HbA_(1c)≥6.0% had significant increased disorder indexes than those with HbA_(1c)<6.0%.527 subjects who had HbA_(1c)≥6.0%or FPG≥6.1 mmol/L underwent OGTT.A total of 234 subjects were newly diagnosed diabetes,including 123(123/234,52.56%) with FPG≥7.0 mmol/L,and 111 subjects(111/234, 47.43%) with isolated 2 h-PG≥11.1 mmol/L.Among 234 new diabetes,91.88%(215 subjects) had HbA_(1c)≥6.3%,and 77.40%(181 subjects) had HbA_(1c)≥6.5%.HbA_(1c)≥6.3%combined FPG≥7.0 mmol/L increased the positive rate of newly diagnosed diabetes from 91.88%to 96.58%. Conclusions:HbA_(1c) is a practical and convenient tool for screening undiagnosed diabetes in routine health check-up of a large population.Combined use of HbA_(1c)≥6.3%and/or FPG≥7.0 mmol/L is efficient for early detection of diabetes.

Prevalence and risk factors of asymptomatic peptic ulcer disease in Taiwan

AIM:To investigate the prevalence and risk factors of asymptomatic peptic ulcer disease(PUD)in a general Taiwan Residents population. METHODS:From January to August 2008,consecutive asymptomatic subjects undergoing a routine health check-up were evaluated by upper gastrointestinal endoscopy.Gastroduodenal mucosal breaks were carefully assessed,and a complete medical history and demographic data were obtained from each patient.Logistic regression analysis was conducted to identify indepen-dent risk factors for asymptomatic PUD. RESULTS:Of the 572 asymptomatic subjects,54(9.4%) were diagnosed as having PUD.The prevalence of gastric ulcer,duodenal ulcer and both gastric and duodenal ulcers were 4.7%,3.9%,and 0.9%,respectively. Multivariate analysis revealed that prior history of PUD [odds ratio(OR),2.0,95%CI:1.3-2.9],high body mass index[body mass index(BMI)25-30:OR,1.5,95%CI: 1.0-2.2;BMI>30 kg/m 2 :OR,3.6,95%CI:1.5-8.7] and current smoker(OR,2.6,95%CI:1.6-4.4)were independent predictors of asymptomatic PUD.In contrast, high education level was a negative predictor of PUD (years of education 10-12:OR,0.5,95%CI:0.3-0.8; years of education>12:OR,0.6,95%CI:0.3-0.9). CONCLUSION:The prevalence of PUD in asymptomatic subjects is 9.4%in Taiwan.Prior history of PUD, low education level,a high BMI and current smoker are independent risk factors for developing asymptomatic PUD.