scholarly journals The role of psychosocial determinants in predicting adherence to treatment in patient with hypertension

2018 ◽  
Vol 11 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Mohammad Reza Asgari ◽  
Hamid Bouraghi ◽  
Ali Mohammadpour ◽  
Mina Haghighat ◽  
Raheleh Ghadiri
Keyword(s):  
Social Support ◽  
Health Care ◽  
Self Efficacy ◽  
Access To Health Care ◽  
Perceived Social Support ◽  
Correlation Study ◽  
Adherence To Treatment ◽  
Treatment Access ◽  
Cross Sectional ◽  
Access To Health

Introduction Non-adherence in patients with hypertension directly exacerbates clinical outcomes. The purpose of the present research is to study the recognition of the relationships between the perceived social support and self-efficacy and the satisfaction of health care agents and the interaction of the patient with therapeutic personnel and access to health care and the behaviors of adherence to treatment in the patients who suffer hypertension. Materials and methods This descriptive cross-sectional correlation study recruited 250 patients from a specialized hypertension clinic in Semnan, who completed the following questionnaires: Multidimensional Scale of Perceived Social Support, self-efficacy, adherence to treatment, access to and satisfaction with health care, and the patient’s interaction with treatment personnel. Results An overall statistical description of the sample consists of 89 (35.6%) men and 161 (64.4%) women (SD = 10.41, range = 51.98). Regression coefficient of previous variables (three steps) shows that self-efficacy share, consent form civil services, and job could demonstrate with 99% certainty in the changes of treatment conformity in a meaningful way. Conclusions High self-efficacy, satisfaction with health care, and a favorable job have a high direct effect on adherence to treatment in patients with hypertension and controlling hypertension. Social support and education do not have a significant impact on adherence to treatment.

An Introduction to Global Health Delivery

2021 ◽  
Author(s):  
Joia Mukherjee ◽  
Paul Farmer
Keyword(s):  
Health Care ◽  
Global Health ◽  
Access To Health Care ◽  
Right To Health ◽  
Treatment Access ◽  
The Road ◽  
Health Delivery ◽  
Positive Side ◽  
Access To Health ◽  
The Right

What has called so many young people to the field of global health is the passion to be a force for change, to work on the positive side of globalization, and to be part of a movement for human rights. This passion stems from the knowledge that the world is not OK. Impoverished people are suffering and dying from treatable diseases, while the wealthy live well into their 80s and 90s. These disparities exist between and within countries. COVID-19 has further demonstrated the need for global equity and our mutual interdependence. Yet the road to health equity is long. People living in countries and communities marred by slavery, colonialism, resource extraction, and neoliberal market policies have markedly less access to health care than the wealthy. Developing equitable health systems requires understanding the history and political economy of communities and countries and working to adequately resource health delivery. Equitable health care also requires strong advocacy for the right to health. In fact, the current era in global health was sparked by advocacy—the activist movement for AIDS treatment access, for the universality of the right to health and to a share of scientific advancement. The same advocacy is needed now as vaccines and treatments are developed for COVID-19. This book centers global health in principles of equity and social justice and positions global health as a field to fulfill the universal right to health.

scholarly journals Predictors of Health Care Seeking Pace Among Newly-Diagnosed Pulmonary Tuberculosis Patients In Cebu City, Philippines: A Cross-Sectional Study

2019 ◽  
Author(s):  
MARK JOHNUEL MATABILAS DUAVIS1
Keyword(s):  
Social Support ◽  
Health Care ◽  
Marital Status ◽  
Perceived Social Support ◽  
Social Stigma ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Perceived Dangerousness

Abstract Background Tuberculosis remains a major public health dilemma in the Philippines. While free and effective TB diagnosis and treatment have been made available since 1996, a number of patients still delay accessing them re­sulting to increased TB mortality and community transmission. This study is aimed at determining the significant variables that can predict a TB patient’s pace in seeking appropriate health care. Methods A descriptive, correlational cross-sectional survey was done to 127 newly-diagnosed TB patients from 10 government-owned TB DOTS facilities in Cebu City. Participants were categorically grouped into Prompt Health Seekers and Delayed Health Seekers using a norm-referenced median dichotomy. Descriptive and inferential analysis utilized included Chi-square Test, Pearson’s Correlation and Discriminant Analysis. Results A mean health care seeking delay of 59 days (median=49) was recorded. Most of the participants experienced unexplained cough which they perceived as only slightly dangerous. 38% of them reported not knowing any symptom related to TB while 39% were not aware of the free public TB services. Most patients have made 2-3 prior health recourses, mostly through self-medication, before finally contacting a DOTS facility. Marital status (p=0.004), the number of symptoms experienced (p=0.000), first symptom experienced (p=0.016), perceived dangerousness of all symptoms experienced (p=0.009), perceived dangerousness of the first symptom experienced (p=0.001), perceived social stigma (p=0.035) and, perceived social support (p=0.002) were found to be significantly associated with the patients’ health care seeking pace. Extending to multivariate analysis, five independent variables namely marital status (p=0.037), number of symptoms experienced (p=0.018), perceived dangerousness of all the symptoms experienced (p=0.028), perceived social stigma (p=0.026) and, perceived social support (p=0.001) can significantly predict the patients’ health care seeking pace. Conclusion A considerable health care seeking delay of 59 days was documented, especially among those with lower perception of social support, higher perception of social stigma and those who do not currently have partners. Patients who experienced more symptoms and those who view these symptoms as less dangerous were, however, likely to seek immediate health care. Reducing health care seeking delays through intensified health information campaigns, strengthening social support systems and reducing social stigma is recommended.

scholarly journals Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

2019 ◽  
Author(s):  
Jacqueline Warth ◽  
Marie-Therese Puth ◽  
Ulrike Zier ◽  
Niklas Beckmann ◽  
Johannes Porz ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
General Practitioner ◽  
Educational Level ◽  
Financial Distress ◽  
Access To Health Care ◽  
Physician Communication ◽  
Financial Problems ◽  
Cross Sectional ◽  
Access To Health

Abstract Background About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to health care. However, it is unclear whether those affected discuss their financial problems with general practitioners that often serve as patients’ initial medical contact. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. Methods We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate: 50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Results Less than one fourth of respondents had ever discussed financial problems with their general practitioner (n=135; 22.6%). Individuals with a high educational level were less likely to communicate about financial problems compared to those with medium educational level (aOR 0.11; 95% CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background (aOR 2.09; 95% CI 1.32-3.32), the chronically ill (aOR 1.90; 95% CI 1.16-3.13) and individuals who reported high financial distress (aOR 2.15; 95% CI 1.22-3.78) and cutting on necessities to pay for medications (aOR 1.86; 95% CI 1.12-3.09) were more likely to report communication than their counterparts after adjustment. Conclusions Few over-indebted individuals discussed financial problems with their general practitioner. The findings suggest that patients’ health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

scholarly journals Health and suffering are associated with social support: a cross-sectional study of women and mothers with exhaustion and pain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anja Gebhardt ◽  
Ann Langius-Eklöf ◽  
Susanne Andermo ◽  
Maria Arman
Keyword(s):  
Social Support ◽  
Health Care ◽  
Meaning In Life ◽  
Perceived Social Support ◽  
Reference Sample ◽  
Subjective Health ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Her Family ◽  
Two Samples

Abstract Background Despite women are generally overrepresented in behavioral, mental, and musculoskeletal disorders, motherhood as a central part of women’s life is poorly understood in relation to exhaustion and long-lasting pain. Mothers’ health impairments imply suffering both for herself and her family. A profound understanding of health is needed taking mothers’ subjective health experience, their suffering and life situation into account to give women, their families and society better prerequisites to alleviate exhaustion and long-lasting pain. The aim of the study was to describe health and suffering of women and mothers undergoing rehabilitation for long-lasting pain and exhaustion and its correlation with perceived social support. Methods The study had a cross-sectional design with an exploratory approach. A main sample consisted of 166 women undergoing rehabilitation for exhaustion and long-lasting pain and a reference sample included 129 women working and studying within health care professions. Both samples included women with and without children. Women’s subjective health and suffering was assessed from a caring science perspective using the recently developed and validated Health and Suffering Scale. Two additional scales measuring exhaustion and social support were distributed among the two samples. Descriptive statistics and multiple linear regression models, including health and suffering and perceived social support, were analyzed. Results Mothers undergoing rehabilitation for pain and exhaustion reported significantly poorer health and more suffering compared to healthy mothers, but similar health and suffering when compared with childless women in rehabilitation. Health and suffering were correlated with perceived social support among both healthy and exhausted mothers. In both samples, the correlation between health and suffering and social support was stronger among mothers than among women without children. Conclusions Women and mothers living with exhaustion and long-lasting pain show signs of unbearable suffering and perceived insufficient social support. Social support from various sources particularly helps mothers to create meaning in life and make their suffering bearable. Hence, health care must address the fact that mothers are dependent on their immediate social environment and that this dependency interacts with their health and suffering on an existential level.

scholarly journals Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongjie Sha ◽  
Willa Dong ◽  
Weiming Tang ◽  
Lingling Zheng ◽  
Xi Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Minority Stress ◽  
Access To Health Care ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gender Minority ◽  
Care Services ◽  
Access To Health ◽  
And Gender

Abstract Background Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China. Methods This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service. Results Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98). Conclusions Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.

scholarly journals Access to health care for patients with thalassaemia in Greece: a cross-sectional study

2020 ◽  
Vol 26 (12) ◽  
pp. 1482-1492
Author(s):  
Kyriakos Souliotis ◽  
Christina Golna ◽  
Sofia Nikolaidi ◽  
Georgia Vatheia
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Access To Health Care ◽  
Cross Sectional Study ◽  
Social Needs ◽  
Sectional Study ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Beta Thalassaemia ◽  
Access To Health

Background: The prevalence and clinical burden of beta-thalassaemia in Greece is high. Little information is available on the unmet needs of patients with beta-thalassaemia and barriers to access to care. Aims: This study investigated barriers that patients with transfusion-dependent beta-thalassaemia in Greece face when accessing care and the associations between socioeconomic factors and access to care. Methods: A cross-sectional study was conducted between November 2018 and January 2019. The sample consisted of 116 beta-thalassaemia patient-members of two Panhellenic patient associations for people with thalassaemia. All respondents were transfusion-dependent. The survey customized and used the Patient Access Partnership 5As of access tool to measure participants’ access to health care services (subscales: accessibility, adequacy, affordability, appropriateness and availability). Data on their socioeconomic characteristics were also recorded. The association between the total score of each subscale and patient characteristics was examined using the Mann–Whitney or Kruskal–Wallis tests. Results: Respondents considered inpatient services less adequate and appropriate, and outpatient services and laboratory tests less affordable. Outpatient services were also perceived as less available. Participants’ income was statistically significantly associated with all the subscales except accessibility, and rural residence was significantly associated with all five subscales. Conclusion: Barriers in access to health care among beta-thalassaemia patients receiving transfusions still persist, especially for those who live far from transfusion centres and have lower incomes. It is important to understand and map current unmet medical and social needs of beta-thalassaemia patients in Greece, in order to design and implement a targeted health policy that can measurably improve patients’ lives.

Indicators of child health in pastoral communities in the Karakoram and Hindukush mountains, Pakistan

2021 ◽  
pp. 1-9
Author(s):  
Spenta Kakalia ◽  
Admin
Keyword(s):  
Health Care ◽  
Dairy Products ◽  
Access To Health Care ◽  
Health Indicators ◽  
Northern Pakistan ◽  
High Mountains ◽  
Cross Sectional ◽  
Access To Health ◽  
Pastoral Communities ◽  
Women And Children

Abstract Pastoralism is practiced in remote parts of the Karakoram and Hindukush high mountains, which sprawl across Northern Pakistan, with women and children travelling to high pastures with their animals during summer. There is no road access; glaciers and hazardous terrain accentuate their remoteness. This was a cross-sectional observational study, carried out along Pakistan’s border with Afghanistan’s Wakhan province. A questionnaire was used to collect basic health data. Height / length, and weight were also measured; 35 children were included in the study. This paper offers preliminary conclusions about health indicators and access to health care. For children in the pastures, health care, and other amenities entail long and sometimes hazardous journeys. Living at high altitudes with their livestock, nutrition consists almost exclusively of wheat (roti) and dairy products. Continuous...

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