scholarly journals Patient desire for spiritual assessment is unmet in urban and rural primary care settings

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph R. Fuchs ◽  
Jeffrey W. Fuchs ◽  
Joshua M. Hauser ◽  
Marilyn E. Coors
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Health Outcomes ◽  
Medical Care ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Spiritual Assessment ◽  
The Past ◽  
Rural And Urban

Abstract Background Incorporation of patient religious and spiritual beliefs in medical care has been shown to improve the efficacy of medical interventions and health outcomes. While previous study has highlighted differences in patient desire for spiritual assessment based on patient religiosity, little is known about patient desire for spiritual assessment based on community type, particularly in urban compared to rural communities. We hypothesized that, given demographic trends which show a higher degree of religiosity in rural areas, patients in rural communities will be more likely to desire spiritual assessment. Methods In this cross-sectional study of 141 adult primary care patients in rural and urban Colorado at non-religiously affiliated clinics, we surveyed patient demographic information, measures of religiosity, patient desire for spiritual assessment, and frequency of spiritual assessment in practice. Univariate logistic regression analyses were used to compare the two populations. Results In both Denver County (urban) and Lincoln County (rural) over 90% of patients identified as religious, spiritual, or a combination of the two. Thirty eight percent (38.3%) of patients in Denver County and 49.1% of patients in Lincoln desired spiritual assessment. Over 97% of patients in both areas reported rarely or never being asked about their R/S within the past year. For patients who have had five or more clinic visits in the past year, more than 91% in both areas stated they have never or rarely been asked about their beliefs. Conclusions While the majority of patients in this study identify as religious or spiritual and many patients desire spiritual assessment, the majority of patients have never or rarely been asked about their spirituality within the past year. This demonstrates a significant gap between patient preference and provider practice of spiritual assessment in the primary care setting, which was similar in both rural and urban settings. This highlights the need for interdisciplinary focus on spiritual assessment and incorporation of patient R/S beliefs in medical care to provide holistic patient care and improve health outcomes.

scholarly journals Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study

2021 ◽  
pp. 095646242110150
Author(s):  
Doreen Nabukalu ◽  
Matthew Ponticiello ◽  
Thomas Bennett ◽  
Sunday Clark ◽  
Rachel King ◽  
...  
Keyword(s):  
Rural Communities ◽  
Hiv Testing ◽  
Cross Sectional Study ◽  
Traditional Healers ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Past ◽  
Male Clients ◽  
Hiv Test ◽  
Testing Uptake

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.

scholarly journals The Quality of Life of Coronavirus Disease Survivors Living in Rural and Urban Area of Riau Province, Indonesia

2022 ◽  
Vol 14 (1) ◽  
pp. 33-42
Author(s):  
Suyanto Suyanto ◽  
Shashi Kandel ◽  
Rahmat Azhari Kemal ◽  
Arfianti Arfianti
Keyword(s):  
Quality Of Life ◽  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Status ◽  
Rural And Urban Area

This study assesses the status of health-related quality of life (HRQOL) among coronavirus survivors living in rural and urban districts in Riau province, Indonesia. The cross-sectional study was conducted among 468 and 285 Coronavirus disease (COVID-19) survivors living in rural and urban areas, respectively in August 2021. The St. George Respiratory Questionnaire (SGRQ) was used to measure the HRQOL of COVID-19 survivors. A higher total score domain corresponds to worse quality of life status. Quantile regression with the respect to 50th percentile found a significant association for the factors living in rural areas, being female, having comorbidities, and being hospitalized during treatment, with total score of 4.77, 2.43, 7.22, and 21.27 higher than in their contra parts, respectively. Moreover, having received full vaccination had the score 3.96 in total score. The HRQOL of COVID-19 survivors living in rural areas was significantly lower than in urban areas. Factors such as living in rural areas, female sex, having comorbidities, and history of symptomatic COVID-19 infection were identified as significant predictors for lower quality of life. Meanwhile, having full vaccination is a significant predictor for a better quality of life. The results of this study can provide the targeted recommendations for improvement of HRQOL of COVID-19 survivors.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Multimorbidity Among Migrant and Non-Migrant Ghanaians: The RODAM Study

2021 ◽  
Vol 66 ◽  
Author(s):  
Anna Marzà-Florensa ◽  
Daniel Boateng ◽  
Charles Agyemang ◽  
Erik Beune ◽  
Karlijn A. C. Meeks ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Cross Sectional ◽  
Middle Income ◽  
Migrant Populations ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Prevalence Ratios

Objectives: Multimorbidity is a growing public health concern due to the increasing burden of non-communicable diseases, yet information about multimorbidity in low- and middle-income countries and migrant populations is scarce. We aimed to investigate the distribution and patterns of multimorbidity in rural and urban areas in Ghana and Ghanaian migrants in Europe.Methods: The RODAM cross-sectional study included 4,833 participants. Multimorbidity was defined as presence of multiple non-communicable chronic conditions. Patterns were determined from frequent combination of conditions. Prevalence ratios were estimated by logistic regression.Results: Prevalence of multimorbidity was higher in women and in urban Ghana and Europe. We observed a cardiometabolic pattern in all sites as well as circulatory-musculoskeletal and metabolic-musculoskeletal combinations in Ghana. Multimorbidity prevalence ratios were higher in Europe (men 1.47, 95% CI 1.34–1.59, women 1.18, 1.10–1.26) and urban Ghana (men 1.46, 1.31–1.59, women 1.27, 1.19–1.34).Conclusion: Distribution and patterns of multimorbidity differed by sex and site. With a higher burden of multimorbidity in urban areas, prevention strategies should focus on forestalling its increase in rapidly growing rural areas.

scholarly journals Mental health and its influencing factors among left-behind children in South China: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiu Zhang ◽  
Mengjie Li ◽  
Li Guo ◽  
Yanna Zhu
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Urban Areas ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Left Behind ◽  
Rural And Urban ◽  
Communication Frequency

Abstract Background With rapid development of China’s economy, there were over 68.7 million left-behind children (LBC) in China whose mental health has become a problem of public concern. The present cross-sectional study aimed to investigate the status of mental health and its associated factors of LBC aged 3–16 years old in both rural and urban areas. Methods A total of 4187 children (aged 3–16), including 1471 LBC and 2716 non-left-behind children (NLBC), were recruited from 50 communities (22 in urban areas and 28 in rural areas) in Guangdong, China in August, 2014. The mental health problems were assessed using the Strength and Difficulties Questionnaire (SDQ). Results No statistically significant difference of SDQ subscales scores about difficulties were found between LBC and NLBC on the whole participants as well as in rural areas or in urban areas within the same age group after adjustments were made (all p > 0.05). However, compared with NLBC in the same areas, urban LBC tended to have higher prosocial behaviours scores, while rural LBC had the lowest prosocial behaviours scores not only in the whole age group but also in different age subgroups (p < 0.05). Besides, compared with urban LBC, rural LBC were not worse in SDQ subscales scores except for prosocial behaviour at 7–9 age group (p = 0.003). Furthermore, higher paternal educational level and longer duration of parental absence, were associated with less difficulties in both rural and urban LBC. Besides, shorter duration of talk per-time but higher communication frequency were associated with less difficulties in rural LBC. Conclusions The present study demonstrated that in general, no difference of mental health problems were found between LBC and NLBC. Besides, longer duration of parental absence, shorter duration of talk per time but more communication frequency, and higher paternal educational level tend to have better development of mental health. The findings reinforce the importance of the stability of caregivers and the effective parent-child communication for Chinese rural LBC.

Tantalus and the Tyranny of Territory: Pursuing the dream of parity in rural and metropolitan population health outcomes through primary health care programs

2004 ◽  
Vol 10 (3) ◽  
pp. 83 ◽  
Author(s):  
Peter Harvey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Communities ◽  
Health Outcomes ◽  
Rural Health ◽  
Rural Areas ◽  
Access To Health Care ◽  
Fundamental Problem ◽  
Primary Health ◽  
Rural And Urban

Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives, such as the Enhanced Primary Care (EPC) program, be vehicles for achieving more equitable health care arrangements and health outcomes for people living in rural communities?

scholarly journals Determinants of child malnutrition in rural and urban Ecuadorian highlands

2013 ◽  
Vol 17 (9) ◽  
pp. 2122-2130 ◽  
Author(s):  
Johana Ortiz ◽  
John Van Camp ◽  
Sylviana Wijaya ◽  
Silvana Donoso ◽  
Lieven Huybregts
Keyword(s):  
Rural Areas ◽  
Maternal Education ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
Rural And Urban ◽  
Sociodemographic Determinants ◽  
Urban And Rural Areas ◽  
Maternal Bmi

AbstractObjectiveTo identify and compare the sociodemographic determinants of stunting, wasting and overweight among infants of urban and rural areas in the Ecuadorian highlands.DesignCross-sectional study.SettingNabon (rural) and Cuenca (urban) cantons, Azuay Province, Ecuador.SubjectsA total of 703 children aged 0–24 months and their caregivers (227 rural and 476 urban) recruited during the period from June to September 2008.ResultsStunting prevalence was significantly higher in the rural area (37·4 %v. 17·7 %;P< 0·001) while wasting (7·1 %) and overweight (17·1 %) prevalence were more similar between areas. Determinants of stunting for the pooled sample were male gender (OR = 1·43; 95 % CI 1·06, 1·92;P= 0·02), preterm delivery (OR = 1·65; 95 % CI 1·14, 2·38;P= 0·008), child's age (OR = 1·04; 95 % CI 1·01, 1·07;P= 0·011), maternal education (OR = 0·95; 95 % CI 0·92, 0·99;P= 0·025) and facility-based delivery (OR = 0·57; 95 % CI 0·45, 0·74;P< 0·001). The latter was also a determinant of overweight (OR = 0·39; 95 % CI 0·25, 0·62;P< 0·001). Rural determinants of stunting were maternal height (OR = 0·004; 95 % CI 0·00004, 0·39;P= 0·018), diarrhoea prevalence (OR = 2·18; 95 % CI 1·13, 4·21;P= 0·02), socio-economic status (OR = 0·79; 95 % CI 0·64, 0·98;P= 0·030) and child's age (OR = 1·07; 95 % CI 1·02, 1·11;P= 0·005). Urban determinants were: maternal BMI for stunting (OR = 0·91; 95 % CI 0·84, 0·99;P= 0·027), cough prevalence (OR = 0·57; 95 % CI 0·34, 0·96;P= 0·036) and facility-based delivery (OR = 0·25; 95 % CI 0·09, 0·73;P= 0·011) for overweight, and hygiene for wasting (OR = 0·57; 95 % CI 0·36, 0·89;P= 0·013).ConclusionsInfant malnutrition was associated with different sociodemographic determinants between urban and rural areas in the Ecuadorian highlands, a finding which contributes to prioritize the determinants to be assessed in nutritional interventions.

scholarly journals Prevalence Of Refractive Errors In School Going Children In Rural And Urban Areas -A Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 22-27
Author(s):  
Dr. Chimata Triveni ◽  
◽  
Dr. Tirumuru Divya ◽  
Dr. Ponna Rama Devi ◽  
Dr. N. Lakshmi Chowdary ◽  
...  
Keyword(s):  
Refractive Error ◽  
Rural Areas ◽  
Urban Areas ◽  
Study Groups ◽  
Cross Sectional Study ◽  
P Value ◽  
Refractive Errors ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban

Introduction: Visual impairment affects students’ routine schoolwork and day-to-day activities.Hence, the aim is to study the prevalence of various refractive errors and their comparison amongschool children of 5-15 years in rural and urban areas. Methods: This cross-sectional studyexamined 998 students from both rural and urban schools. After obtaining ethical clearance andinformed consent, students were examined for refractive errors. The students with the refractiveerror were given a socio-demographic questionnaire and questionnaire regarding their usage oftelevision, computer, and family history of refractive errors. A Chi-square test was used to test thestatistical significance of proportions. P-value < 0.05 was considered statistically significant, anddata were analyzed by using coGuide software, V.1.03 Results: The prevalence of refractive errorwas found to be 6.41 %, with a prevalence of 7.61% in urban and 5.21% in rural areas. Thedifference in the type of refractive error between the study groups was found to be insignificant,with P= 0.897. Conclusion: Prevalence of refractive errors was more in urban school children thanrural. Refractive error was more prevalent in 13-15 years age group in both rural and urban schoolchildren. The most common refractive error was myopia, followed by astigmatism andhypermetropia.

scholarly journals Comparing knowledge of diabetes mellitus among rural and urban diabetics

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Ahmad Ayaz Sabri ◽  
Muhammad Ahad Qayyum ◽  
Naif Usman Saigol ◽  
Khurram Zafar ◽  
Fawad Aslam
Keyword(s):  
Diabetes Mellitus ◽  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Mean ◽  
Question Survey ◽  
Awareness Level

A questionnaire-based cross-sectional study was carried out to assess the awareness of diabetes mellitus among rural and urban diabetics. After analyzing the awareness level of both populations, the urban diabetics were found to be more educated about diabetes. A 25-question survey was used to judge the awareness level of diabetes mellitus. A total of 240 diabetics were surveyed, 120 each from rural and urban areas. The mean awareness among the rural population was 13 (SD± 2) correct answers out of a possible 25. Similarly, in the case of the urban diabetics the mean awareness was 18 (SD± 2) correct answers. The survey was conducted on randomly chosen diabetics belonging to Lahore and Faisalabad, (urban areas), as well as Habibabad, Haveli Koranga and Baba Kanwal (rural areas). The results emphasize the interrelation between demography and awareness of diabetes mellitus. The rural diabetics are far less knowledgeable about diabetes mellitus, its management and its complications. Thus, there is an urgent need to improve the awareness level of diabetes mellitus in rural areas. Doing so will give rise to a healthier workforce and a lessened economic burden on Pakistan.

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