Self-Medication during Eye Affections among Consultant Patients at Chu-Iota

Introduction: According to the World Health Organization (WHO), self-medication consists in the fact that an individual resorts to a drug, on his own initiative or that of a loved one, with the aim of treating an ailment or a symptom that he identified himself without having recourse to a health professional. Self-medication involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. The aim of this study is to determine the different characteristics of ophthalmic self-medication at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients of any age who resorted to ophthalmological self-medication before the first consultation or during the ophthalmological care of consulting patients at the CHU-IOTA between January 1 and July 31, 2021. Results: Over the period, 521 cases of ophthalmological self-medication were collected out of a total of 24,512 consultations, which corresponds to a frequency of 2.12%. The average age was 37.7 years, [2 months - 78]. The sex ratio was 0.50. Economic factors were the main factor mentioned, 66.79%. Corticosteroids accounted for 45.26% of the pharmacological class with dexamethasone/neomycin eye drops being the most widely used, i.e. 22.94%. The most common complication was corticosteroid-induced ocular hypertension on ametropia, i.e. 15.54%. Our patients were 68.13% educated. Among his educated patients 53.35% had no knowledge of the products. Conclusion: Given the harm associated with this practice, awareness and information campaigns aimed at the population, caregivers and pharmacists or pharmacy vendors are necessary in order to reduce the frequency of the practice of self-medication.

High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and good management of MSDs whose chronicity generates a disability.

Medication Use by Runners in Self-Care Situations

The benefits of running for cardiovascular health have long been established, but no relationship between runners/non-runners and their usage of prescription and over-the-counter (OTC) medications has been established. A comprehensive survey was sent out via Facebook, Inc., to self-identified runners to assess runners’ first response to 5 common self-care situations. The results were compared to the national average of the U.S. population who take prescription and OTC medications. What was also assessed was the relationship between average weekly miles run and the likelihood to choose OTC medications. 714 runners, residing predominately in the St. Louis, Missouri metropolitan area, completed the survey and their results were drastically different than the national average use for prescription and OTC medication in the general (non-runners) population. Approximately 30% of the runners in this study are on daily prescription medications versus a national average of 70% of the U.S. population. In each of the 5 common self-care situations, less than 50% of runners chose an OTC medication as their first option for self-care vs. the national average of 80%. Results of the study also showed that runners with a weekly mile average of 30 miles or more were less likely to choose an OTC option for self-care than runners with a weekly average of 15 miles or less. Overall, results of this survey suggest that runners are less likely to take medications and may be healthier than the average U.S. citizen overall.

Self-Medication for Oral Health Problems among Dental Outpatients at a Nigerian Tertiary Hospital

Background: Self-medication is the inappropriate use of drugs to treat self-diagnosed disorders or symptoms. Even though Self-medication has benefits as it enhances better use of clinical skills and increases access to medication;it is also associated with risks such as adverse drug reactions and antibiotics resistance. Objectives: To determine prevalence of self-medication practices among dental out-patients, triggering factors that influence self-medication practice and common source of drugs. Materials and methods: This descriptive cross-sectional study was conducted at the Clinic of the Department of Preventive Dentistry, Lagos University Teaching Hospital over a period of 6 months using self-administered questionnaires adapted from previous studies. Data obtained was analysed and expressed as frequencies and percentages. Test of associations was done using chi-square (p Results: Age of respondents ranged from 16 to 78 years (32.24 ± 13.47). M:F was 1:1. Prevalence of self-medication was 45.5%;toothache was the most prevalent reason for self-medication (71%). The frequently used drugs for self-medication were analgesics (65%) while the most common source for the drugs was the pharmacy (60%). Educational status (X2 = 12.85, P 2 = 6.42, P 2 = 10.38, P Conclusion: This study revealed high prevalence of self-medication with toothache as the predominant trigger and pharmacy, the most common source.

Self-Medication among Adults in Minia, Egypt: A Cross Sectional Community-Based Study

Self-medication may be associated with side effects and increases the chance of drug interactions and also affects the adherence to treatment and quality of life. This study aims at determining the pattern of self-medication, identifying knowledge, attitude and self-reported practices concerning the usage of the drugs and identifying demographic factors that could influence self-medication practices among the general population in El-Minia, Egypt. A community-based cross-sectional study was conducted among 422 randomly selected adults using a multi-stage random sampling technique. Data were collected by using a structured interview questionnaire. Respondents who had practiced some sort of self-medication during the past month were 73% of the sample. The commonest cause of self-medication, illness, was perceived as minor (59.7%). The most common perceived illness for self-medication was common cold (90.6%). Older respondents (>40 years) were about twice more likely to practice self-medication than younger ones. Similarly, professionals in their work were 3.4 times more likely to practice self-medication than unemployed individuals. Self-medication is a relatively frequent problem in Minia and interventions at different levels are required.

Self-Medication Practice among Pharmacists in UAE

Objectives: The purpose of this study was to determine the incidence of self-medication behavior among practicing pharmacists in UAE. Methods: This anonymous questionnaire-based study was conducted between October and December 2014, using a prepiloted questionnaire. The questionnaire was distributed to a total of 168 pharmacists. Data were analyzed using SPSS and results were expressed as number of respondents and percentage of total participants. Results: The questionnaire was completed by 149 pharmacists, and response rate was 89% with 53% of respondents being Arabs. Out of the 149 pharmacists respondents, 71 (47.7%) are males, and 78 (52.3%) are females. The mean age among pharmacists was 28. Large number of pharmacists practiced self-medication (96.6%). The majority obtained their medication from pharmacies (92.6%). Most respondents were aware of bacterial resistance and the concept of rational drug use. However, 69 (43%) of pharmacists had used antibiotics without consultation in the past year. The main reasons for self-medication were that their health problem is not serious (42%) and their knowledge on drugs and diseases helps (31%). Reasons against self-medication included risk of misdiagnosis of illness and risk of adverse effects. Pharmacists tended to seek medical consultation mostly in case of symptoms lasting for more than one week or when symptoms were worsening. Discussion: The frequency of self-medication among pharmacists is high. The professional exposure to drugs and knowledge of illness and treatment choice remains the fundamental contributors to self-medication practice among pharmacists. Interventions to promote rational self-medication among practicing pharmacists are required and pharmacists must be encouraged to enter the patient role.

Awareness and Practice of Proper Health Seeking Behaviour and Determinant of Self-Medication among Physicians and Nurses in a Tertiary Hospital in Southwest Nigeria

Background: There is generally a lack of good health-seeking practices among health professionals due to a variety of factors, including the intensity of the medical practice itself. Doctors and nurses are perceived to have a good knowledge of ideal health-seeking behaviors and as such, it is important to determine the level of their awareness and estimate whether this knowledge is put into practice. This study, therefore, aimed to determine the level of awareness and practices of proper health-seeking behavior and to identify the factors responsible for self-medication among doctors and nurses in a tertiary hospital in Nigeria. Methodology: A cross-sectional descriptive study was conducted between April and may 2018 among 106 doctors and 164 nurses in a tertiary health facility in Ido-Ekiti, Ekiti State, Southwestern Nigeria. A simple random sampling technique by balloting was performed from the list of doctors and nurses in the hospital to select doctors and nurses that participated in the study. A pretested semi-structured self-administered questionnaire was designed and used to collect data. The data were entered into the computer software and analyzed using SPSS version 20. P ≤ 0.05 was taken as significant. Result: Out of 106 doctors and 164 nurses recruited, only 102 doctors and 143 nurses filled the questionnaire completely and returned for analysis. One hundred and four respondents (42.4%) fall within the ages of 31 - 40 years with a male to female ratio of 1:1.23. Awareness of proper health seeking behavior among both doctors and nurses was high among the two groups with no statistically significant difference between them. Twenty-nine (28.0%) doctors compared with thirty-four (23.8%) nurses go for a regular medical check-up with no statistically significant difference between the two groups (p = 0.411). Out of these, 5 (17.2%) doctors and 7 (23.8%) nurses visit at an interval of less than 6 month (p = 0.736). There is a statistically significant difference in the number of doctors (60.8%) compared with nurses (41.3%) that have consulted a doctor in the last one year (p = 0.003). More than half (51.6%) of this consultation among doctors was over the phone whereas 64.4% of such among nurses were via clinic appointment (p = 0.008). More doctors (90.2%) comply with their treatment prescription from physicians compared with nurses (77.6%) (p = 0.010). More nurses compared with doctors self-medicate when ill [Doctor 61.8% (63), Nurses 78.3% (112)] (p = 0.005) and had also self-medicated in the last one year [Doctor 34.3% (35), Nurses 42.7% (61)] (p = 0.187). Decreasing age, decreasing years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services are factors that significantly increased the likelihood of self-medication among doctors and nurses within the last one year. Conclusion: Awareness of proper health seeking behavior was high but this did not translate into proper health-seeking practices among doctors and nurses. There is apathy for regular medical check-up and self-medication was also high among this group of health workers. Decreasing age and years of experience, increasing working hours, lack of health insurance, fear of confidentiality and lack of satisfaction with health services were factors were identified to significantly increase the likelihood of self-medication.

Self-Medication Practice against Malaria and Associated Factors in the City of Parakou in Northern Benin: Results of a Population Survey in 2017

Introduction: Self-medication is a common practice in Benin. It has many consequences on people’s health in general and develops chemoresistance in particular. Aim: The aim of this work is to study the practice of anti-malarial self-medication in the city of Parakou and to identify the associated factors with this practice. Methods: This was a descriptive cross-sectional analytical survey that took place in the period from April 15 to June 24, 2017. Adults who reported having had malaria symptoms in the last 6 months before the survey and living in 9 neighbourhoods randomly selected in the city of Parakou were included. A structured questionnaire collected their self-medication habit, the drugs used, the supply places and the reasons for this practice. Data were analysed using the Epi-data 3.1 software. Results: Of the 335 respondents included in this study, 141 (42.09%) had self-medicated including 130 (38.81%) with anti-malarial drugs. Fever is the main symptom of malaria cited by respondents (129% or 38.51%) followed by headache (93% or 27.76%). The most commonly used anti-malarial drugs for self-medication are quinine (60% or 44.45%) followed by artemisinin-based combination therapy (46% or 34.07%). Eighty-seven respondents (66.92%) did not have a good knowledge of the drug dosage. Reasons for self-medication were mainly the high cost of consultation fees (99% or 54.10%) and good knowledge of one’s illness (53% or 28.96%). Self-medication associated factors were fever (p = 0.04), non-prescription drugs supply in pharmacies (p Conclusion: Self-medication is a common practice in the city of Parakou. Medicines purchased without prescription in pharmacies and drugs availability in street facilitate this practice, which may compromise the effectiveness of anti-malarial drugs.

Development of a Self-Assessment Questionnaire for Nurses’ Risk-Taking Behavior in Medication

Purpose: The purpose of this study was to prepare a self-assessment questionnaire for nurses’ risk-taking behavior (RTB) in medication and to develop a reliable and valid questionnaire. Method: In the first study, a draft of the self-evaluation questionnaire for nurses’ RTB in medication was prepared based on the literature study and qualitative analysis of important case information included in the Project to Collect Medical Near-miss/Adverse Event Information Annual Report of the Ministry of Health, Labor and Welfare. Following the studies, face validity was confirmed, and a questionnaire survey was conducted for nurses who oversee medication nationwide to verify the reliability and validity. Result: The number of subjects was 586 (valid response rate: 94.1%). Item analysis and exploratory factor analysis showed that 4 factors and 12 items for the RTBs in daily life and 4 factors and 20 items for RTBs in medication could be extracted. Confirmatory factor analysis confirmed the fit of the hypothetical model obtained by exploratory factor analysis. In addition, Cronbach’s α coefficient was 0.888. Thus, high reliability and validity were obtained. A correlation was found by comparing the total scores of each RTB factor with the incident/accident group, and a standard for self-evaluation value could be established (p < 0.01). Conclusions: We were able to develop a self-assessment questionnaire for nurses’ risk-taking behavior in medication. This questionnaire will be used by nurses to find out their trends.

Short‐term and long‐term memory self‐attention network for segmentation of tumours in 3D medical images

Tumour segmentation in medical images(especially 3D tumour segmentation)is highly challenging due to the possible similarity between tumours and adjacent tissues,occurrence of multiple tumours and variable tumour shapes and sizes.The popular deep learning‐based segmentation algorithms generally rely on the convolutional neural network(CNN)and Transformer.The former cannot extract the global image features effectively while the latter lacks the inductive bias and involves the complicated computation for 3D volume data.The existing hybrid CNN‐Transformer network can only provide the limited performance improvement or even poorer segmentation performance than the pure CNN.To address these issues,a short‐term and long‐term memory self‐attention network is proposed.Firstly,a distinctive self‐attention block uses the Transformer to explore the correlation among the region features at different levels extracted by the CNN.Then,the memory structure filters and combines the above information to exclude the similar regions and detect the multiple tumours.Finally,the multi‐layer reconstruction blocks will predict the tumour boundaries.Experimental results demonstrate that our method outperforms other methods in terms of subjective visual and quantitative evaluation.Compared with the most competitive method,the proposed method provides Dice(82.4%vs.76.6%)and Hausdorff distance 95%(HD95)(10.66 vs.11.54 mm)on the KiTS19 as well as Dice(80.2%vs.78.4%)and HD95(9.632 vs.12.17 mm)on the LiTS.

基于对比学习MocoV2的COVID-19图像分类

肺炎是一种常见多发感染性疾病,老年人和免疫力较弱者容易感染,尽早发现有助于后期治疗。肺部病变的位置、密度和清晰度等因素会影响肺炎图像分类的准确性。随着深度学习的发展,卷积神经网络被广泛应用于医学图像分类任务中,然而网络的学习能力依赖训练样本的数量和标签。针对电子计算机断层扫描(Computed Tomography,CT)的肺炎图像分类研究,提出一种基于自监督对比学习的网络模型(MCLSE),可以从无标记的数据中学习特征,提高网络模型的准确率。本文模型(MCLSE)首先设计辅助任务,从无标记的图像中挖掘表征完成预训练,提高模型在向量空间中学习数据映射关系的能力。其次,使用卷积神经网络提取特征,为了有效捕获更高层次的特征信息选择SENet网络改进分类模型,建模特征通道的相关性。最后,用训练好的权重加载改进后的分类模型中,下游任务中使用标记数据再次训练网络。在公开数据集SARS-CoV-2 CT和CT Scans for COVID-19 Classification上进行实验,实验结果表明MCLSE对整体样本分类的准确率分别达到99.19%和99.75%,较主流模型有很大提升。

基于信息-动机-行为模型的护理干预对造口患者并发症及生活质量的影响

目的探讨与分析基于信息-动机-行为(IMB)模型的护理干预对造口患者并发症及生活质量的影响。方法选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多(P<0.05)。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多(P<0.05)。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多(P<0.05)。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低(P<0.05),护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低(P<0.05)。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高(P<0.05)。结论基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。

Assessing the reasons for increase in self‑medication and control measures among student nurses in University of Benin Teaching Hospital, Edo State, Nigeria

Background:Self‑medication among student nurses is the use of medicines without doctor’s prescription.This practice is a global phenomenon and potential contributor to human resistance to most drugs,associated with different types of health challenges.Despite the high knowledge on the complication of self‑medication,studies showed that most student nurses still practice self‑medication.Aims:The aim of this study was to assess the reasons for increase in self‑medication and and find ways on how to curbing the menace among student nurses in the School of Nursing,University of Benin Teaching Hospital,Edo State,Nigeria.Materials and Methods:A descriptive cross‑sectional survey was conducted with stratified simple random sampling technique to select ninety student nurses from three different levels in the School of Nursing,University of Benin Teaching Hospital in Benin City,Edo State.A self‑structured questionnaire with open‑type and Likert‑type scale questions used as instrument to assess the reasons for increase in self‑medication and the possible control measures.Data collected were analyzed using tables,percentages,means,standard deviation,and t‑test for inferential statistics at 0.05 level of significance,through Statistical Package for the Social Sciences software.Results:The result showed the reasons for increase in self‑medication and how to reduce its occurrence.It also showed that the gender of the student nurses is statistically related to the reasons why they practice self‑medication(t=6.82,P≤0.001).Conclusion:Self‑medication can be reduced among student nurses by empowering the law enforcement agencies against self‑medication,improving the availability of essential and quality drugs in school clinics,and inclusion of all student nurses in National Health Insurance Scheme(NHIS)program,where they can enjoy the benefit of paying only 10%of the treatment charges.

Pharmacist Opportunities to Improve Public Self-Medicating Practices in the UAE

Objective: Self-treatment is an important aspect of self-care and one of the vital issues under debate in health care. Self-medication patterns vary among different populations and are influenced by many factors. The objective was to investigate the nature of self-medication behavior among the general public in the UAE and to explore public attitudes, beliefs, and level of knowledge concerning self-medication. Methods: A purposive sample of individuals involved in self-medication who belong to different age, gender, income, education level and health-seeking behaviors. A qualitative approach through individual face-to-face interviews was utilized to investigate participants’ behaviors and attitudes towards self-medication;factors influencing decision to self medicate, sources of information on medications, types of conditions for which self-medication is sought and types of medications used. Participant recruitment continued until theme saturation using content analysis. Findings: Three themes emerged from the data: Reasons for self-medication such as costs associated with visiting a doctor, convenience in visiting a pharmacy and perception of simplicity of the condition;Sources of information: pharmacists as a main source in addition to medication leaflets, family role and previous use, and medicines and medicines’ use: medicines’ use in chronic disease, use of antibiotics, use of herbals and supplements and medicines’ use in children. Conclusion: Findings from this study indicate that self-medication behaviors are common among the population due to several reasons. Inappropriate self-medication practices are evident and may compromise patient care outcomes. Pharmacists play a vital role in intervening to optimize the use of medications and patient education regarding self-care.

FOCUS-PDCA循环管理对心血管内科门诊患者自护能力及用药依从性的影响

目的探讨FOCUS-PDCA循环管理对心血管内科门诊患者自护能力及用药依从性的影响。方法选取2020年2月至2021年3月于抚州市第一人民医院心血管内科门诊就诊的82例患者作为对照组,另选取2021年4月至2022年5月于抚州市第一人民医院血管内科门诊就诊的80例患者作为观察组。观察组采用FOCUS-PDCA循环管理,对照组采用普通管理,比较两组干预前后自护能力评分及药依从率、疾病知晓率、治疗满意率。结果干预前,两组自护责任、健康知识、自我概念、护理技能评分及总评分比较差异无统计学意义;干预后,两组自护责任、健康知识、自我概念、护理技能评分及总评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组用药依从率、疾病知晓率、治疗满意率均高于对照组,差异有统计学意义(P<0.05)。结论FOCUS-PDCA循环管理可提高心血管内科门诊患者自护能力及其对疾病的认知,提高患者用药依从率及治疗满意率。

基于赋能模式的健康教育对慢性鼻-鼻窦炎患者术后自护能力、遵医行为及不适症状的影响

目的探讨基于赋能模式的健康教育在慢性鼻-鼻窦炎(CRS)患者中的应用效果。方法选取2021年6月至2023年6月上饶市人民医院收治的88例CRS患者作为研究对象,按照随机数字表法分为对照组(n=44)和观察组(n=44)。对照组采用常规护理方法,观察组在常规护理基础上行基于赋能模式的健康教育方法,均连续护理至患者出院。比较两组患者自我护理能力、遵医行为、不适症状以及生活质量。结果护理后,观察组自我护理能力测定量表(ESCA)各项评分、遵医行为中遵医用药和鼻腔清洗等维度评分、生活质量综合评定问卷(GQOLI-74)评分均高于对照组,差异有统计学意义(P<0.05);观察组不适症状各项评分均低于对照组,差异有统计学意义(P<0.05)。结论CRS患者接受基于赋能模式的健康教育干预后,可加快提升患者自护能力,有效改善患者遵医行为,减轻患者术后不适症状,提升生活质量。

On the Risks of Medicalization of Adolescents Self-Injuring Acts

Although common among community adolescents, self-injuring acts are mainly studied by psychiatrists and psychologists and rarely by social work researchers. The preponderance of medical research in the field has come to associate self-injuring acts with mental issues. This view has to a large extent been adopted among professionals as well as among laypeople. When examining adolescents’ unsolicited internet published narratives, this medicalization of self-injuring acts was found to have negative consequences for disclosure and help-seeking, and hence limit the adolescents’ possibilities to get adequate help and support. The main objective of this work is to study adolescents’ views on hampering factors for help-seeking for self-injuring acts and the role of medicalisation for their willingness for disclosure and help-seeking. Disclosure of self-injuring acts within the social network was described as met with demands to seek professional mental help. Seeking professional help was accompanied with fear of being perceived as crazy or diagnosed as mentally ill. Internet websites were described as value free and safe arenas giving opportunity to disclose self-injuring acts without fear of being stigmatized and labelled as mentally ill. An extended involvement of social work researchers and professionals, approaching self-injuring acts not primarily as a sign of mental problems, but as an adolescent way of trying to manage a complicated social context, could enhance finding adequate support systems. It is also necessary that the medical profession contributes to a demedicalization of self-injuring acts.

Effect of Medical Advice for Diet on Diabetes Self-Management and Glycemic Control for Haitian and African Americans with Type 2 Diabetes

Adequate care of type 2 diabetes is reflected by the individual’s adherence to dietary guidance;yet, few patients are engaged in diabetes self-care at the recommended level, regardless of race/ethnicity. Few studies on the effect of dietary medical advice on diabetes self-management (DSM) and glycemic control have been conducted on Haitian and African American adults with type 2 diabetes. These relationships were assessed in total of 254 Blacks with type 2 diabetes (Haitian Americans = 129;African Americans = 125) recruited from Miami-Dade and Broward Counties, Florida by community outreach methods. Although dietary advice received was not significantly different between the two Black ethnicities, given advice “to follow a diet” as a predictor of “using food groups” was significant for Haitian Americans, but not for African Americans. Haitian Americans who were advised to follow a diet were approximately 3 times more likely to sometimes or often use food groups (or exchange lists) in planning meals. Less than optimal glycemic control (A1C > 7.2) was inversely related to DSM for African Americans;but the relationship was not significant for Haitian Americans. A one unit increase in DSM score decreased the odds ratio point estimate of having less than optimal glycemic control (A1C > 7.2%) by a factor of 0.94 in African Americans. These results suggest that medical advice for diet plans may not be communicated effectively for DSM for some races/ethnicities. Research aimed at uncovering the enablers and barriers of diet management specific to Black ethnicities with type 2 diabetes is recommended.

互联网模式下的学校-医院-家庭健康管理模式在学龄期癫痫患儿中的应用

目的:探讨互联网模式下的学校-医院-家庭健康管理模式对学龄期癫痫患儿服药依从性、自尊水平及心理状态的影响。方法:选取2020年1月—2021年12月收治的98例学龄期癫痫患儿作为研究对象,采用随机数字表法将患儿分为对照组和观察组各49例。对照组给予常规干预措施,观察组给予互联网模式下的学校-医院-家庭健康管理模式。比较两组患儿服药依从性、自尊水平、心理状态。结果:观察组患儿服药依从性高于对照组(P<0.05);观察组患儿干预后森伯格自尊心量表(SES)评分、缺陷感量表(FIS)评分均高于对照组(P<0.05),儿童焦虑性情绪障碍筛查表(SCAREO)评分、儿童抑郁障碍自评量表(DSRSC)评分均低于对照组(P<0.05)。结论:互联网模式下的学校-医院-家庭健康管理模式能够有效提高学龄期癫痫患儿服药依从性,改善不良心理状态及自尊水平。

GMAS、MMAS-8和SEAMS评估慢性病病人用药依从性效能的比较

目的:比较普适性药物依从性量表(GMAS)、Morisky服药依从性测量量表(MMAS-8)、合理用药自我效能量表(SEAMS)在慢性病病人中的应用效果,为临床选择有价值的慢性病用药依从性评估工具提供参考。方法:于2021年10月—2022年2月选取在天津市3所医疗机构就诊的270例成年慢性病病人为研究对象,采用一般资料调查表、GMAS、MMAS-8、SEAMS进行用药依从性评估,并以MAQ作为效度评价标准,采用受试者工作特征(ROC)曲线、Bayes判别分析、Kappa一致性检验和阳性似然比对3种慢性病用药依从性评估工具进行比较。结果:以MAQ为评价标准,270例病人中用药依从性差者122例(45.2%)。GMAS、MMAS-8、SEAMS评分的ROC曲线下面积(AUC)分别为0.981,0.984,0.917,灵敏度分别为0.987,0.993,0.676,特异度分别为0.926,0.943,0.951,约登指数分别为0.913,0.936,0.627(P<0.001)。GMAS、MMAS-8和SEAMS对评估慢性病病人用药依从性的交叉检验准确率分别为89.6%、97.0%和80.7%,与MAQ评估结果的一致性检验Kappa值分别为0.917,0.940,0.608(P<0.001),阳性似然比分别为13.367,17.303,13.734。结论:3种量表在评估慢性病病人是否存在用药依从性不佳风险时均有较高价值,其中MMAS-8评估慢性病病人用药依从性的效能最高,GMAS量表次之,最后是SEAMS,提示研究人员可根据研究对象个性化特点和研究目的针对性地选择评估工具,有助于准确识别用药依从性不佳的慢性病病人并早期开展干预。