scholarly journals A magyarországi várandósgondozási rendszer sajátosságai: a magán- és állami ellátások igénybevétele mögött húzódó egyenlőtlenségek

2021 ◽  
Vol 162 (35) ◽  
pp. 1402-1412
Author(s):  
Julianna Boros ◽  
Krisztina Kopcsó ◽  
Zsuzsanna Veroszta
Keyword(s):  
Health Status ◽  
Pregnant Women ◽  
Psychological Symptoms ◽  
Mental Wellbeing ◽  
Occupational Prestige ◽  
Psychological Variables ◽  
Pregnancy Care ◽  
Health Visitors ◽  
Health Related ◽  
Partnership Status

Összefoglaló. Bevezetés: Jóllehet Magyarországon a várandósok a társadalombiztosítási rendszer által támogatott komplex várandósgondozási ellátásra jogosultak, mégis sokan vesznek közülük igénybe privát szolgáltatásokat. Ezt a döntést többek között a biztonságérzet fokozása és a várandósgondozást végző szakember szülésig tartó folytonosságának biztosítása motiválja. Nemzetközi szakirodalmi adatok alapján mindemellett feltételezhető, hogy hazánkban is befolyásolja a választást a társadalmi-gazdasági helyzet. Célkitűzés: A jelen elemzés célja annak vizsgálata magyarországi várandósok reprezentatív mintáján, hogy az állami/magán/vegyes finanszírozású várandósellátás igénybevétele mennyiben kapcsolódik bizonyos demográfiai, szocioökonómiai, egészségi és pszichológiai változókhoz. Módszer: Az elemzés a Kohorsz ’18 Magyar Születési Kohorszvizsgálat első, várandós anyák körében zajló szakaszának súlyozott adatain történt (n = 8287). Az adatok forrását a védőnők által szóbeli interjúk során felvett, valamint önkitöltős formában begyűjtött kérdőíves adatok szolgáltatták. Eredmények: Az egyes várandósgondozási formák igénybevétele erősen összefüggött a várandós korával, iskolai végzettségével, anyagi helyzetével és foglalkozási presztízsével. Közepes erősségű kapcsolatban állt a várandós partnerkapcsolati helyzetével és meglévő gyermekeinek számával, míg gyenge összefüggésben az egészségi állapotával és pszichés tüneteivel. A finanszírozási formához mindemellett erősen kapcsolódott az, hogy a várandós választott orvossal, szülésznővel tervezte-e szülését. Megbeszélés: A kapott eredmények rámutatnak, hogy a várandósellátás különböző finanszírozású formáinak igénybevétele jelentős mértékben együtt jár a várandós szocioökonómiai és demográfiai sajátosságaival, míg egészségi és pszichés állapotával csupán gyenge összefüggésben áll. Következtetés: A hazai várandósgondozást jellemző kettős finanszírozás háttér-egyenlőtlenségek egész sorát hordozza magában. Jövőbeli elemzésekben vizsgálat tárgyává szükséges tenni, hogy ez mennyiben mutat összefüggést ellátásminőségi és -hozzáférési különbségekkel, valamint ezeken keresztül a várandós és gyermeke egészségével. Orv Hetil. 2021; 162(35): 1402–1412. Summary. Introduction: While pregnant women in Hungary are entitled to complex pregnancy care financed by the social security system, many of them do use private services. This decision is motivated, among other things, by increasing the sense of security and ensuring the presence of the doctor providing pregnancy care at the birth. However, based on the international literature, it can be assumed that this decision is influenced by the socio-economic background as well. Objective: The aim of the present analysis is to examine the extent to which the use of public/private/mixed funded pregnancy care is related to certain demographic, socioeconomic, health related and psychological variables on a representative sample of pregnant women in Hungary. Method: The analysis was performed on the weighted data of the first, pregnant wave of the Cohort ’18 Growing Up in Hungary (n = 8287). The analysis is based on data from personal interviews and self-administered questionnaires conducted by the health visitors among pregnant women in 2018. Results: The use of different forms of pregnancy care was strongly related to the age of the pregnant women, their education, financial situation and occupational prestige. It was moderately correlated with the pregnant woman’s partnership status and their parity, while it was weakly correlated with her health status and psychological symptoms. The form of financing of the pregnancy care was, however, strongly related to whether the pregnant woman planned to give birth with a chosen doctor or midwife. Discussion: The results show that the use of different forms of pregnancy care is greatly associated with the socioeconomic and demographic characteristics of the pregnant women, while it is only weakly related to the health status and mental wellbeing. Conclusion: Double funding in the Hungarian pregnancy care system carries a whole range of background inequalities. Future analyses should examine whether this has an impact on the quality and availability of care and, indirectly, on the health of pregnant women and their children. Orv Hetil. 2021; 162(35): 1402–1412.

Effectiveness of Oral Health Promotion by Community Health Workers in Reducing Periodontal Diseases among Pregnant Women

2020 ◽  
Author(s):  
Sania Sania
Keyword(s):  
Health Promotion ◽  
Health Status ◽  
Oral Health ◽  
Pregnant Women ◽  
Oral Hygiene ◽  
Health Workers ◽  
Periodontal Diseases ◽  
Oral Health Status ◽  
Oral Health Promotion ◽  
Health Related

Background: Poor periodontal conditions among pregnant women might be a risk factor for adverse pregnancy outcomes which include preeclampsia, preterm delivery, intrauterine growth restriction, and fetal demise (stillbirth). Aim: To assess the effectiveness of oral health promotion by community health workers in diminishing periodontal diseases among pregnant women in rural areas of Jammu District. Methodology: In this community-based cluster randomized controlled study, Jammu district was divided into 5 administrative provinces with a total of 16 PHCs. In our study baseline assessment of Oral Health-related Knowledge, Attitude and Practices, and Oral health status using Oral Hygiene Index was done among pregnant women. Trained ASHA workers served as a medium to impart oral health education to pregnant females on a regular basis. After 3 months of follow up in the 2nd trimester, again oral health-related knowledge, attitude and practices, and oral health status using Oral Hygiene Index were assessed and oral prophylaxis was done for all pregnant women. After 4-5 months birth outcomes were collected at PHC's. Results: The knowledge about oral health was poor in pregnant women, and it improved after providing health education in pregnant women. Scaling alone as an independent variable did not influence the reduction in the preterm birth week (p= 1.000) and birth weight (p=0.113) at 2ndtrimester of pregnancy. Conclusion: Sociocultural factors, illiteracy, misconception, and the extra burden of work on ASHA workers are the main reasons for the ineffective transfer of knowledge and very little change in oral health behavior in pregnant women.

scholarly journals Characteristics of health behaviours and health status indicators among pregnant women in Slovenia

2017 ◽  
Vol 86 (7-8) ◽  
Author(s):  
Tina Kek ◽  
Nataša Karas Kuželički ◽  
Irena Mlinarič Raščan ◽  
Ksenija Geršak
Keyword(s):  
Health Status ◽  
Pregnant Women ◽  
Smoking Status ◽  
Heart Defects ◽  
Health Behaviours ◽  
Multivitamin Supplementation ◽  
Medication Intake ◽  
Nulliparous Women ◽  
Health Related ◽  
Health Related Behaviour

Background: Pregnancy is a period when women reconsider their own health and health related behaviour for the sake of their future child. Along with their health providers, they are faced with a number of risk assessments and decisions, which become far more complex as their effect on two organisms rather than one is at play. This paper provides an overview of possible associations between self-reported health status, health behaviours and socio-demographics during pregnancy.Methods: Study data were obtained from the case-control research project “Analysis of folate metabolism biomarkers in the risk assessment for neural tube defects, orofacial clefts and congenital heart defects”, which recruited participants from May 2013 to September 2015. Questionnaires about maternal health, health related behaviour and socio-demographic characteristics were completed by 450 women. The data include pregnancies from the 1980s to 2015.Results: We observed that younger and less educated women more frequently reported positive smoking status during pregnancy, while higher prevalence of folate/multivitamin supplementation was found among more educated, older and nulliparous women. There was a U-shaped distribution of medication intake (over-the-counter and prescribed) with respect to educational level, with the highest intake in mothers with a masters/PhD degree and among those that completed elementary school. Higher medication usage was also reported among older women. With increasing maternal age there was an increase in medication intake, folate/multivitamin intake, as well as incidence of gestational diabetes over the studied time period, with the highest frequencies occurring in later decades. A higher incidence of chronic diseases was observed in a group of multiparous women than among monoparous women.Conclusions: Considerable socio-demographic disparities exist in health-related behaviour among pregnant women. Improved public health campaigns and individual health care counselling are needed to address specific requirements of socio-demographic groups at higher risks of adverse pregnancy outcomes.

Mental Health Status and Health-Related Quality of Life among Systemic Lupus Erythematosus (SLE) Patients in Thailand: A Multi-Site Study

2020 ◽  
Vol 103 (11) ◽  
pp. 1185-1193
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Status ◽  
Lupus Erythematosus ◽  
Self Esteem ◽  
Mental Health Status ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead to low health-related quality of life (HRQoL). However, limited research has been done in this area. Objective: To examined mental health status and HRQoL among SLE patients in Thailand. Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL. Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self-esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60. Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications. Keywords: Mental health, Quality of life, SLE, Thailand

scholarly journals P139 What impact does JIA have on health-related quality of life over time and by gender?

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Andrew Smith ◽  
Bishma Saqib ◽  
Rebecca Lee ◽  
Wendy Thomson ◽  
Lis Cordingley
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Child Health ◽  
Reference Population ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Over Time ◽  
Domain Scores

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritic conditions presenting in children and young people, in which physical limitations and associated complications can have detrimental effects on physical and psychosocial wellbeing. This study aims to investigate the impact of living with JIA on different aspects of health-related quality of life (HRQoL) and to explore how this changes over time, using data from the Childhood Arthritis Prospective Study (CAPS). Methods Longitudinal data collected as part of CAPS were analysed. HRQoL was assessed at baseline, 1 year and 3 years’ post-diagnosis using the Child Health Questionnaire (CHQ), a parent-completed form for children from 5 years of age. The CHQ measures physical, emotional and social components of child health status. Raw domain scores were transformed via algorithm into values ranging from 0-100, with higher scores indicating better health status. Mean (standard deviation) and median (interquartile range) for each domain were determined, both for the full cohort and by gender. Differences between median scores at baseline and 3 years were assessed using the Wilcoxon signed-rank test. Mean scores of each domain were visually compared with a reference population sample of healthy children from the United States. Results 184 participants completed the questionnaire at all 3 time points. At baseline, compared to the reference population, children with JIA scored lower in every domain although scores were closer between the 2 groups at 3 years. Median scores improved over time, the exception being the general health perceptions domain which decreased after baseline. Domains with the greatest improvement were physical functioning,“bodily pain and social-physical. The largest changes occurred from baseline to 1 year. Statistically significant differences between baseline and 3-year scores were found for all domains. Domain scores for male and female participants were very similar at baseline, though scores for male participants indicated slightly better health at 1 and 3 years for both physical and psychosocial domains. Conclusion JIA has significant impact on HRQoL, which improves within 3 years of diagnosis with the greatest improvement occurring within the first year. Physical health domains show greater improvement over time than psychosocial domains, although psychosocial scores were generally higher throughout the study. Male participants tend to score slightly higher than female participants in both physical and psychosocial domains after baseline. Further research should explore measurable patient, age or disease-related drivers of HRQoL. Disclosures A. Smith None. B. Saqib None. R. Lee None. W. Thomson None. L. Cordingley None.

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