A Cross-sectional Survey of Urban and Rural Residents' Perceptions About the Medical System Services in a Middle Province of China

Abstract Background: To investigate urban and rural residents' perceptions on the issue of "difficult access to quality medical services and expensive medical bills" (difficult and expensive medical services) 10 years after the implementation of medical and health care system reform in China.Methods: we conducted a cross-sectional questionnaire survey of residents in a middle province of China. Multi-stage stratified random sampling was utilized to sample a total of 1968 residents of three cities in the middle province in July 2019. Results: Residents in the province were highly satisfied with the solution of "difficult and expensive medical services", with the satisfaction rate reaching 70%. However, satisfaction differed among the surveyed cities. 83.4% of the residents reported "difficult and expensive medical services"as their current major concern. Complex medical procedures (31.25%) and high inspection costs (51.68%) were the main reasons for "difficult and expensive medical services". Other reasons include the provision of medical and health resources, the service awareness of medical and health care personnel, people's health needs, and the perceptions of health, etc. Conclusions: The issue of "difficult and expensive medical services" is a social issue requiring constant attention.

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Evaluation of health system in Iraq from people's point of view: a comparative study of two different eras

Journal of Ideas in Health ◽

10.47108/jidhealth.vol4.iss2.100 ◽

2021 ◽

Vol 4 (2) ◽

pp. 380-387

Author(s):

Saad Ahmed Ali Jadoo ◽

Adil H. Alhusseiny ◽

Shukr Mahmood Yaseen ◽

Mustafa Ali Mustafa Al-Samarrai ◽

Anmar Shukur Mahmood

Keyword(s):

Health System ◽

Health Sector ◽

Health Resources ◽

Sampling Technique ◽

Point Of View ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Current Health ◽

Multi Stage ◽

Geographical Regions

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001), and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

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Opportunistic infections among people living with HIV at reference health care centers in Morocco, 2015 (Preprint)

10.2196/preprints.14229 ◽

2019 ◽

Author(s):

Noureddine Sakhri ◽

Fatima Zahra Meski ◽

SOUMIA TRIKI

Keyword(s):

Health Care ◽

Opportunistic Infections ◽

Oral Candidiasis ◽

Clinical Stage ◽

Bivariate Analysis ◽

People Living With Hiv ◽

Cross Sectional Survey ◽

Pneumocystis Jiroveci ◽

Cross Sectional ◽

Health Care Centers

BACKGROUND Morbidity and mortality in HIV disease is due to immune-suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In 2015, the HIV prevalence is low in general population and concentrated among key populations. OBJECTIVE This study aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending antiretroviral health care in Morocco, during 2015. METHODS We conducted a cross-sectional survey among all adult PLHIV for admitted in the health care centers during 2015, who had acquired infection disease. Patients’ opportunistic infection status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. The clinical stage of HIV was identified by the classification of Centers for Disease Control and Prevention (CDC). We collected Socio-demographic and clinical data from patients’ medical records. We performed statistical analysis by using Epi-Info 7.2.0.1 software. The appropriate test was applied, bivariate analysis was made and the differences were significant when p<.05. RESULTS 299 HIV-infected cases were included; 53% were males. The most represented age group was 25-34 years (36.1%). The mean age of the cases was 38.7 ± 16.8. The prevalence of OIs was 47.8%. Tuberculosis (65/299, 21.7%), Pneumocystis jiroveci pneumonia (40/299, 13.4%) and Oral candidiasis (22/299, 7.4%) were the most frequently observed OIs. CONCLUSIONS Tuberculosis, pneumocystis and oral candidacies were the leading OIs, encountered by HIV-infected cases. Preventive measures and early diagnosis of HIV associated to OIs are crucial.

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COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116076 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6076

Author(s):

Hasan S. Alamri ◽

Wesam F. Mousa ◽

Abdullah Algarni ◽

Shehata F. Megahid ◽

Ali Al Bshabshe ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care Workers ◽

Psychological Impact ◽

Psychological Outcomes ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Care Workers ◽

The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

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Perceived Oral Health Literacy, Behaviors, and Oral Health Care among Caregivers to the Homebound Population

Home Health Care Management & Practice ◽

10.1177/10848223211008435 ◽

2021 ◽

pp. 108482232110084

Author(s):

Agata Wilk ◽

Lisa LaSpina ◽

Linda D. Boyd ◽

Jared Vineyard

Keyword(s):

Health Care ◽

Oral Health ◽

Health Literacy ◽

Oral Care ◽

Oral Health Care ◽

The Body ◽

Current Evidence ◽

Oral Health Literacy ◽

Cross Sectional Survey ◽

Cross Sectional

This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score ( M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score ( M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.

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Determinants of successful guideline implementation: a national cross-sectional survey

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01382-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ying-hui Jin ◽

Li-Ming Tan ◽

Khalid S. Khan ◽

Tong Deng ◽

Chao Huang ◽

...

Keyword(s):

Guideline Development ◽

Guideline Implementation ◽

Medical Specialty ◽

Cross Sectional Survey ◽

The West ◽

Cross Sectional ◽

Adherence To Guidelines ◽

Multi Stage ◽

Geographical Regions ◽

Tertiary Hospitals

Abstract Background CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China. Methods This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2–5 provinces were selected from each region. 2–3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. Finally, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results The questionnaire consisted of four sections: knowledge of methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P < 0.001; the west P = 0.02; the middle P < 0.001 compared with the east), hospital grades (P = 0.028), length of practitioners’ practice (P = 0.006), education background (Ph.D., P = 0.027; Master, P = 0.002), evidence-based medicine skills acquired in work unit (P = 0.012), and medical specialty of practitioner (General Practice, P = 0.006; Surgery, P = 0.043). Conclusion Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.

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

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008390 ◽

2009 ◽

Vol 20 (5) ◽

pp. 346-350 ◽

Cited By ~ 5

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.

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72 Perceptions of the COVID-19 Vaccine Amongst Health Care Workers in a Southeast Michigan Hospital: A Cross-Sectional Survey

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2021.07.074 ◽

2021 ◽

Vol 78 (2) ◽

pp. S34-S35

Author(s):

T. Choi ◽

K. Pitus ◽

J. Boura ◽

C. Pearson ◽

J. Stav

Keyword(s):

Health Care ◽

Health Care Workers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Workers

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Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system

Clinical Infectious Diseases ◽

10.1093/cid/ciab054 ◽

2021 ◽

Author(s):

Jana Shaw ◽

Telisa Stewart ◽

Kathryn B Anderson ◽

Samantha Hanley ◽

Stephen J Thomas ◽

...

Keyword(s):

Health Care ◽

Vaccine Development ◽

Direct Care ◽

Healthcare Personnel ◽

Care Providers ◽

Cross Sectional Survey ◽

Allied Health Professionals ◽

Cross Sectional ◽

Vaccination Programs ◽

To Receive

Abstract Background As a priority group, healthcare personnel (HCP) will be key to success of COVID-19 vaccination programs. The purpose of this study was to assess HCP willingness to get vaccinated and identify specific concerns that would undermine vaccination efforts. Methods We conducted a cross-sectional survey of HCP, including clinical and non-clinical staff, researchers, and trainees between November 23 rd ,2020 and December 5 th ,2020. The survey evaluated attitudes, beliefs and willingness to get vaccinated. Results A total of 5287 respondents had a mean age of 42.5 years (SD=13.56), and were 72.8% female (n=3842). Overall 57.5 % of individuals expressed intent to receive COVID-19 vaccine. 80.4% were physicians and scientists representing the largest group. 33.6% of registered nurses, 31.6% of allied health professionals, and 32% of master’s level clinicians were unsure they would take the vaccine (p<.001). Respondents who were older, males, White, or Asian were more likely to get vaccinated compared to other groups. Vaccine safety, potential adverse events, efficacy and speed of vaccine development dominated concerns listed by participants. Fewer (54.0%) providers of direct care vs. non-care providers (62.4%), and 52.0% of those who had provided care for COVID-19 patients (vs. 60.6% of those who had not) indicated they would take the vaccine if offered (p<.001). Conclusions We observed that self-reported willingness to receive vaccination against COVID-19 differs by hospital roles, with physicians and research scientists showing the highest acceptance. These findings highlight important heterogeneity in personal attitudes among HCPs around COVID-19 vaccines and highlight a need for tailored communication strategies.

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