Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons

2018 ◽  
Vol 28 (9) ◽  
pp. 1395-1405
Author(s):  
Timothy Joseph Sowicz ◽  
Christine K. Bradway
Keyword(s):  
Health Care ◽  
Health Center ◽  
Health Care Providers ◽  
Sexual History ◽  
History Taking ◽  
Care Providers ◽  
Opioid Use ◽  
Factors Affecting ◽  
Sexual History Taking ◽  
Sexual Histories

Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients’ characteristics, communication between patients and HCPs, the prioritization of patients’ basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Planned Behaviour ◽  
Sexual History ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Planned Behaviour

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

Sexual risk assessment in general practice: evidence from a New South Wales survey

Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Asaduzzaman Khan ◽  
David Plummer ◽  
Rafat Hussain ◽  
Victor Minichiello
Keyword(s):  
Risk Assessment ◽  
Sexual Risk ◽  
New South ◽  
New South Wales ◽  
Sexual History ◽  
History Taking ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Sexual History Taking ◽  
Sexual Histories

Background: Physicians’ inadequate involvement in sexual risk assessment has the potential to miss many asymptomatic cases. The present study was conducted to explore sexual risk assessment by physicians in clinical practice and to identify barriers in eliciting sexual histories from patients. Methods: A stratified random sample of 15% of general practitioners (GP) from New South Wales was surveyed to assess their management of sexually transmissible infections (STI). In total, 409 GP participated in the survey with a response rate of 45.4%. Results: Although nearly 70% of GP regularly elicited a sexual history from commercial sex workers whose presenting complaint was not an STI, this history taking was much lower (<10%) among GP for patients who were young or heterosexual. About 23% never took a sexual history from Indigenous patients and 19% never elicited this history from lesbian patients. Lack of time was the most commonly cited barrier in sexual history taking (55%), followed by a concern that patients might feel uncomfortable if a sexual history was taken (49%). Other constraints were presence of another person (39%) and physician’s embarrassment (15%). About 19% of GP indicated that further training in sexual history taking could improve their practice. Conclusions: The present study identifies inconsistent involvement by GP in taking sexual histories, which can result in missed opportunities for early detection of many STI. Options for overcoming barriers to taking sexual histories by GP are discussed.

Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

2018 ◽  
Vol 52 (5) ◽  
pp. 405-414 ◽  
Author(s):  
Natalia Shcherbakova ◽  
Gary Tereso ◽  
Jacqueline Spain ◽  
Robert J. Roose
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Care Providers ◽  
Opioid Use ◽  
Treatment Persistence ◽  
Factors Associated ◽  
Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

Effect of attitudes towards patients on sexual history taking: a survey of Iranian–American physicians in California, USA

Sexual Health ◽  
2017 ◽  
Vol 14 (6) ◽  
pp. 514 ◽  
Author(s):  
Mitra Rashidian ◽  
Victor Minichiello ◽  
Synnove F. Knutsen ◽  
Mark Ghamsary
Keyword(s):  
Female Sexuality ◽  
Healthcare Delivery ◽  
Sexual History ◽  
History Taking ◽  
Cultural Attitudes ◽  
Factors Affecting ◽  
Sexual Health Care ◽  
Medical Graduates ◽  
Sexual History Taking ◽  
Iranian American

Background: Although obtaining sexual history from patients is essential, the attitudes of physicians can become a barrier to sexual health care. Iranian–American physicians may face particular challenges because talking about sexuality is considered a taboo within their culture. Our study examined these physicians’ attitudes when taking a sexual history from their patients. Methods: In 2013, a self-administrated questionnaire was sent to 1550 Iranian–American physicians in California, USA. Using factor analysis, the principal components approach with a Varimax rotation was used on a set of 12-item questions (five-point Likert scales) to detect latent factors that explain attitudes affecting sexual history taking. Scores are generated to determine physicians’ attitudes towards sexual history taking. Results: In total, 354 questionnaires were returned (23% response rate). Three factors were identified as internally consistent (Cronbach’s α = 0.84 – 0.94): (1) attitude towards various patients; (2) female sexuality; and (3) age and marriage. Significant association were found between these three factors and some variables such as physicians’ gender, country of medical graduation, religion, birthplace and age. Conclusions: Results revealed that cultural attitudes are important factors affecting physicians’ involvement in sexual history taking. Additional studies from this population and other subpopulations of US physicians are needed. New strategies that reflect on physicians’ attitude on sexual healthcare delivery is needed. If confirmed in other studies, our findings could have implications for the training of medical graduates globally.

Perceptions of Sexual Assault Victims/Survivors: The Influence of Sexual History and Body Weight

2015 ◽  
Vol 30 (1) ◽  
pp. 66-80 ◽  
Author(s):  
Sandra Gotovac ◽  
Shelagh Towson
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Undergraduate Students ◽  
Health Care Providers ◽  
Sexual History ◽  
Victim Blaming ◽  
Care Providers ◽  
Rape Victims ◽  
Future Health ◽  
Assault Victims

The intersection between a woman’s body weight and sexual history and the victim blaming attitudes of future health care providers was investigated. University undergraduate students (N = 91) enrolled in programs associated with the provision of health care read 1 of 4 patient files of a woman reporting a rape as well as 2 distracter files. Results showed that, for overweight rape victims/survivors, study participants’ antifat attitudes were correlated with victim blaming attitudes. Male participants held the attacker significantly less responsible than did female participants if the victim/survivor had several previous sexual partners. Findings suggest that body weight should be considered as a contributing factor in attitudes toward rape victims/survivors, and the gender of the health care provider can be a factor in the post-assault treatment of overweight rape victims/survivors.

scholarly journals 575Factor affecting job satisfaction and organizational commitment among primary health care providers in Delhi, India

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Pawan Kumar
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Health Care Providers ◽  
Working Environment ◽  
Care Providers ◽  
Factors Affecting ◽  
Organization Commitment ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Career Growth

Abstract Background The purpose of present study was to explore the factors affecting job satisfaction and organizational commitment of primary health care providers working in Government health facilities of Delhi, India. Methods Study was conducted on a sample of 333 health care providers who were selected using multistage simple random sampling technique. Factor analysis of job satisfaction scale, statistical test like multiple regression, correlation tests were applied using SPSS version 18. Results The seven factors affecting job satisfaction emerged from the factor analysis which are; privileges attached with job, interpersonal relation and cooperation, working environment, patient relationship, organization facilities, career development and human resource issues. Nature of job whether regular or contractual explains 25.1% of variance in the job satisfaction of staff (R Square= 0.251, p = 0.000). Nature of job along with level of education of health care providers is affecting 26.5% of variance in job satisfaction (R Square= 0.265, p = 0.015). For organization commitment type of job whether regular or contractual is responsible for 44.7% of variance in the commitment (R square 0.447; p = 0.000) and experience of health care providers is affecting 29.0% of variance in commitment (R square= 0.290; p = 0.000). Other predictors of organization commitment are salary, job security, working environment, appreciation of work and career growth. Conclusion The findings strongly suggest that the mode of entry of employee, privileges, career growth and working atmosphere contribute substantially to the job satisfaction and organization commitment. Key messages Appropriate changes are required at the policy level to keep the human resource satisfied and committed to the organization keeping in consideration the factors responsible for them.

scholarly journals Health Care Access and Utilization for American Indian Elders: A Concept-Mapping Study

2019 ◽  
Vol 76 (1) ◽  
pp. 141-151 ◽  
Author(s):  
David H Sommerfeld ◽  
Elise Trott Jaramillo ◽  
Erik Lujan ◽  
Emily Haozous ◽  
Cathleen E Willging
Keyword(s):  
Health Care ◽  
American Indian ◽  
Concept Mapping ◽  
Health Care Providers ◽  
Health Care Access ◽  
National Policy ◽  
Health Care Use ◽  
Care Providers ◽  
Factors Affecting ◽  
Care Access

Abstract Objectives Inequities in access to and utilization of health care greatly influence the health and quality of life of American Indian elders (AIEs). This study explores the importance and perceived prevalence of factors affecting health care use within this population and assesses the changeability of these factors to produce a list of action items that are timely and relevant to improving health care access and utilization. Method Concept mapping was conducted with AIEs (n = 65) and professional stakeholders (n = 50), including tribal leaders, administrators of public-sector health systems, outreach workers, and health care providers. Data were analyzed using multidimensional scaling and cluster analyses. Results The final concept-map model comprised nine thematic clusters related to factors affecting elder health care: Difficulties Obtaining and Using Insurance; Insecurity from Lack of Knowledge; Limited Availability of Services; Scheduling Challenges; Provider Issues and Relationships; Family and Emotional Challenges; Health-Related Self-Efficacy and Knowledge; Accessibility and Transportation Barriers; and Tribal/National Policy. Discussion Findings suggest that improvements in access to and utilization of health care among AIEs will require actions across multiple domains, including health system navigation services, workforce improvements, and tribal, state, and federal policy. A multilevel socioecological approach is necessary to organize and undertake these actions.

Health providers’ perspectives on medical marijuana use.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 235-235 ◽  
Author(s):  
Diana Martins-Welch ◽  
Christian Nouryan ◽  
Myriam Kline ◽  
Sony Modayil
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Side Effects ◽  
Health Care Providers ◽  
Prescription Drugs ◽  
Medical Marijuana ◽  
The United States ◽  
Care Providers ◽  
Opioid Use ◽  
Cord Injury

235 Background: According to the CDC, 117 million Americans have one or more chronic health conditions and 31% have used two or more prescription drugs in the past month. Approximately 40% of adults in the United States are using some form of Complementary and Alternative Medicine. Medical marijuana is one such medicine, and to date 29 states have legalized medical marijuana. Methods: A multicenter, anonymous, on-line survey of health care providers was distributed via e-mail within a large health system in the NY Metropolitan area. The survey was distributed in April and May of 2017. The specific aim was to collect information about health care providers’ perspectives on the use of MM in general and for specific medical conditions. Results: The sample (n = 137) consisted of 4% RNs, 10% NPs, 10% fellows, 21% resident physicians, and 52% attending physicians. Average experience was 13 years (range: 0-43), half (53%) were under 40 years old and just over half (56%) were female. Most practitioners recognized a benefit of MM for the treatment of cancer-associated symptoms, few were concerned with side effects and 5% of responders answered that MM was not appropriate at any stage of illness. Responders were “most likely to recommend or refer MM if other therapies were not effective” for cancer (83%), chronic pain (68%), spinal cord injury with spasticity (50%), MS (46%), epilepsy (42%), neuropathy (42%) and Parkinson’s disease (41%). Most providers (77%) believed that MM has the potential to reduce overall opioid use, this was found to be statistically more common in younger providers. The most common conditions that providers reported their patients were requesting MM for were cancer (37%), chronic pain (26%) and neuropathy (10%). The most common concerns about MM use were side effects (16%), addiction (13%), legal consequences (11%), cost (7%) and that other providers would judge MM use (7%). Conclusions: Our survey shows that providers are overwhelmingly in support of MM use in patients with chronic illness, particularly in cancer patients. However providers describe significant and practical concerns about MM utilization. Given the rate at which MM is being legalized throughout the country, it is imperative that there be increased focus on education and clinical studies on MM.

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