scholarly journals Understanding Interpersonal Influences on the Use of Formal Health Services among a Population of Iranian Women in Reproductive Age: A Qualitative Study

2019 ◽  
Vol 7 (9) ◽  
pp. 1531-1535
Author(s):  
Mohammad Ali Morowatisharifabad ◽  
Tahereh Rahimi ◽  
Tahmineh Farajkhoda ◽  
Hossein Fallah Zadeh

BACKGROUND: One of the most important factors contributing to using formal health care services by women is people who are involved in the social network around them. AIM: This study aimed to understand the interpersonal influences on the use of formal health services among Iranian women of reproductive age. METHODS: This study is a deductive content analysis approach based on the Health Promotion Model. Twenty-two semi-structured interviews were done with women of reproductive age and health care staffs in Qom, Iran. Transcripts were analysed by a deductive content analysis approach based on the Health Promotion Model (HPM). RESULTS: Three main categories and eight subcategories were drawn consisting of (1) social support with 4 subcategories including “Family support and influence”, “support of religious people”, “support of health care providers” and “negative social support”; (2) social pressure and expectations with 2 subcategories including “feeling pressure due to role-playing” and “society's expectations regarding women's health”, and (3) healthy role models with 2 subcategories including “family role models” and “modeling friends and peers in taking action for treatment”. CONCLUSION: A positive interpersonal influence in women acts as a strong incentive to seek health care when they are suffering from a disease, and prevents the chronicity of the disease by timely treatment.

2019 ◽  
Vol 7 (14) ◽  
pp. 2360-2364
Author(s):  
Faramarz Shaahmadi ◽  
Davoud Shojaeizadeh ◽  
Roya Sadeghi ◽  
Zohreh Arefi

INTRODUCTION: Health promotion behaviours are considered as preventives of non-communicable diseases and key determinants of maintaining and improving the health status. AIM: This study aimed to investigate and identify effective factors on health-promoting behaviours based on Pender model in women of reproductive age from February to April 2017, in Savojbolagh, Iran. METHODS: This cross-sectional study is conducted on 240 women aged between 15 to 49 years in Savojbolagh, Iran, in 2017. The questionnaire consisted of several items, including socio-demographic characteristics, health-promoting lifestyle profile-II (HPLP-II), self-efficacy, social support and constructs of Pender’s health promotion model. SPSS-18 software has been applied for statistical analysis. RESULTS: The mean age of the women was 31.10 ± 7.29 years. Total HPLP-II score was 106.64 ± 11.93. The highest and the lowest mean in the subscales were belonged to nutrition and physical activity, respectively. According to the bivariate analysis, the total HPLP-II score is significantly related to prior health-related behaviour (p = 0.000). There was a statistically significant relationship between stress management and the variables including perceived benefits, perceived barriers, prior health-related behaviour, situational influences, commitment to a plan of action (p < 0.05). Also, health responsibility had a statistically significant relationship with self-efficacy (p < 0.05). CONCLUSION: According to our results, it can be inferred that there is a problem with the HPBs of women. Considering that health-promoting behaviours like physical activity had a low score, it is a necessity to plan and perform interventions for improving health promotion behaviours.


2021 ◽  
Author(s):  
Ebrima Barrow ◽  
Alieu Sowe

Abstract Background: Ability to utilise healthcare services is desire for everyone in need. Unfortunately, challenges to health care utilization persist and they do so inequitably amongst social groups. This study aimed to examine problems to health care utilization and residential area equity in utilization among women of reproductive age in The Gambia. Methods: Data from The Gambia 2019-20 Demographic and Health Survey comprising of 11,865 women 15 – 49 years of age was used. A systematic selection method of equal probability was employed for the data collection interviews. Visiting any health facility in the last 12 months is the outcome. Problems to health care utilization was assessed using four primary factors of interest: permission to go, money needed for treatment, distance to health facility and not wanting to go alone as independent variables. Descriptive and logistic regression analysis were used to assess the frequency distribution and the association of the four factors and health care utilization by residence. The point estimates were reported in odds (OR), 95% confidence interval (CI) and p value <0.05 signified statistical significance.Results: Most women in rural (79%) and urban (83%) residential areas utilized health care services in the last 12 months. Women in urban areas who had a big problem getting permission to go and a big problem not wanting to go alone had lower odds of health care utilization compared to women who did not have a big problem getting permission to go and not wanting to go alone for health care. Women resident in rural areas who reported distance to health facility as a big problem had higher odds of health care utilization compared to women who did not have big problem concerning distance to health facility. Conclusions: Permission to go and not wanting to go alone appear to be associated with cultural norms and inadequate social support for women utilizing health care in urban residence. Policy makers should address harmful cultural norms and inadequate social support for women during health care visits to improve equity in health care utilization towards achieving universal health coverage.


Author(s):  
Ranti Suciati ◽  
Mujiati Mujiati ◽  
Novianti Novianti

Abstrak Semakin meningkatnya jumlah kasus HIV/AIDS di Indonesia, berdampak tidak hanya pada masalah kesehatan, memacu pemerintah untuk melibatkan masyarakat sipil dalam Organisasi Berbasis Komunitas (OBK) untuk ikut berperan dalam upaya pencegahan dan penanggulangan HIV/AIDS. Pentingnya identifikasi kendala atau hambatan yang dihadapi oleh OBK memunculkan strategi atau alternatif solusi untuk mengatasi kendala, serta memberikan gambaran model intervensi yang lebih sinkron antara pemerintah dan masyarakat. Desain penelitian adalah kualitatif dengan melakukan studi kasus di dua LSM Peduli AIDS di Jakarta. Informan dipilih secara purposive sampling yaitu pengurus, anggota/petugas, dan dampingan dari dua OBK. Pengumpulan informasi dengan wawancara mendalam berdasarkan pedoman wawancara dan diolah menggunakan metode content analysis. Kendala yang dihadapi OBK yaitu alur rujukan BPJS yang mengikuti domisili sehingga memberatkan pasien, kurang optimalnya koordinasi dan kerjasama antara OBK dengan Puskesmas, belum meratanya kualitas dan kapasitas SDM anggota OBK, persoalan administratif organisasi, sumber dana yang tidak selalu kontinu, adanya perbedaan kepentingan antara OBK dengan pihak kepolisian, serta masih tingginya stigma masyarakat terhadap penderita HIV/AIDS. Solusi mengatasi kendala OBK dilakukan dengan peningkatan efektifitas pelaksanaan program pemerintah melalui OBK, antara lain dengan penerapan fleksibilitas pengelolaan dana berdasarkan kinerja OBK, peningkatan kapasitas SDM, pemantapan sistem manajerial, pemahaman alur layanan kesehatan di Puskesmas, serta social support bagi penderita HIV/AIDS. Kata kunci: organisasi berbasis komunitas, LSM, HIV/AIDS Abstract The increasing number of HIV/AIDS cases in Indonesia that impact not only on health issues, spur the Government to involve civil society in community-based organizations (OBK) to play a role in HIV/AIDS prevention program. Identification of constraints or obstacles faced by OBK do as they can generate alternative strategies or solutions to overcome these constraints, and provide a more synchronous model of intervention between the government and the community. This type of research is a case study at two AIDS Awareness NGOs in Jakarta. The informants were chosen by purposive sampling ie the board, members/officers, and assistants from the two NGOs. Information collection with by in-depth interview based on interview guideline and processed using content analysis method. Constraints faced by the OBK is the issue of referral flow pathways that follow the domicile so burdensome patients, less optimal coordination and cooperation between OBK with primary health care, uneven quality and capacity of human resources of NGO members, organizational administrative issues, sources of funds that are not always continuous, different interests between the OBK with the police department, and the stigma. Reduction of obstacles faced by OBK can be done by increasing the effectiveness of government program implementation through OBK, among others by applying flexibility of fund management based on OBK performance, human resource capacity building, managerial system strengthening, understanding of health service flow in primary health care, and social support for patient HIV/AIDS. Keywords: community-based organizations, NGOs, HIV/AIDS


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Lundberg ◽  
Mats Jong ◽  
Miek C. Jong ◽  
Lisbeth Porskrog Kristiansen

Abstract Background Previous studies have reported that organizational structures and cultures in primary health care are obstacles to district nurses doing successful work in health promotion practice (HPP). Because organizational structures are not easily changed, Jean Watson’s Attending Nurse Caring Model (ANCM) was introduced and piloted at a primary health care center in Sweden, aiming to transform HPP so as to empower district nurses and increase their work satisfaction. Aim To investigate patients’ experiences of the caring encounter in HPP after introduction of the ANCM in Swedish primary health care, the aim being to explore the essential components of the caring encounter between patients and district nurses. Methods A descriptive and qualitative research design was used. Data collection was performed using individual face-to-face interviews with twelve patients at risk for developing CVD. Data analysis consisted of both deductive content analysis, using a categorization matrix based on the ANCM and, subsequently, inductive latent content analysis. Results The findings were abstracted into three themes: 1.‘Feeling the deepest essence of being cared for’: to be respected and being put at the center of the encounter; 2. ‘Feeling acceptance and worth’: being treated with openness and permissive attitudes, 3. ‘Being in a supportive atmosphere that promotes hope’: to feel trust and being trusted in the encounter, and being empowered by hope. The unifying main theme of the caring encounter was abstracted as ‘Experiencing human dignity’. Conclusion The present study revealed that the essence of the caring encounter between patients and district nurses in HPP is to be unconditionally accepted in an environment that inspires hope and encouragement. The ANCM seems to be a promising model to use for strengthening the caring encounter and supporting CVD patients in making healthy lifestyle choices. However, further studies of qualitative and quantitative designs are needed to investigate what the ANCM can contribute to HPP in Swedish primary health care.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Minh X. Nguyen ◽  
Vivian F. Go ◽  
Quynh X. Bui ◽  
Bradley N. Gaynes ◽  
Brian W. Pence

Abstract Background The HIV epidemic in Vietnam has been primarily driven by injection drug use. HIV-infected people who inject drugs (PWID) in Vietnam have very high rates of mental health problems, which can accelerate progression to AIDS and increase mortality rates. No research has explored the barriers and facilitators of mental health care for HIV-infected PWID in Vietnam. Methods We conducted 28 in-depth interviews among HIV-infected PWID (n = 16), HIV and MMT (methadone maintenance treatment) providers (n = 8), and health officials (n = 4) in Hanoi. We explored participants’ perceptions of mental health disorders, and barriers and facilitators to seeking and receiving mental health care. Results HIV-infected PWID were perceived by both PWID, HIV/MMT providers, and health officials to be vulnerable to mental health problems and to have great need for mental health care. Perceived social, physical, and economical barriers included stigma towards HIV, injection drug use, and mental illnesses; lack of awareness around mental health issues; lack of human resources, facilities and information on mental health services; and limited affordability of mental health services. Social support from family and healthcare providers was a perceived facilitator of mental health care. Conclusions Interventions should raise self-awareness of HIV-infected PWID about common mental health problems; address social, physical, economic barriers to seeking mental health services; and increase social support for patients.


2015 ◽  
Vol 5 (4) ◽  
pp. 18
Author(s):  
Miftachul Munir ◽  
Nursalam . ◽  
R.S. Triyoga

Introduction: The vision of development in East Java is to realize a prosperous society and morals. In order to improve public health, as one of the measures to achieve this vision will require proximity access and improving the quality of health services in the community. Health cottage village (Ponkesdes) is a basic health services located in the village or villages that are part of the development of village midwife (Polindes). The aim of this study was to develop into a Community Nursing Center Ponkesdes based Health Promotion Model Theory, Nursing Center, and Performance Behavior nurse.Methods: The study design was an observational analytic consisting of two phases, namely the implementation of the exploratory and descriptive exploration causa effect. The population used in this study were nurses ponkesdes Tuban district that fit inclusion criteria as much as 20, with a sample of 20 respondents were determined using simple techniques saturated. The independent variable in this study is Nursing Center, Health Promotion and Behavior Model Performance dependent variable is the commitment and the action plan ponkesdes duty nurse. Instruments used in the collection of data in the form of questionnaires and data results focused discussion. Analysis of studies using the Partial Least Square.Results: This study showed a significant effect on Nursing Center nurse commitment Ponkesdes (t = 3.197). Health Promotion Model a significant effect on the commitment of nurses Ponkesdes (t = 2.185). Commitment nurses significantly influence nurses task Ponkesdes (t = 29.546).Discussion and Conclusions: Model development of community nursing center Ponkesdes be very relevant to be applied to programs that can improve the health and can be a solution for institutions of public health services.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11543-11543
Author(s):  
Kelly Marie Trevino ◽  
Christian J. Nelson ◽  
Rebecca Saracino ◽  
Beatriz Korc-Grodzicki ◽  
Saman Sarraf ◽  
...  

11543 Background: Surgery is a notable stressor for older adults with cancer who are often medically complex and frail. The American College of Surgeons Commission on Cancer requires distress screening in accredited cancer care settings. The degree to which distress screening leads to mental health use is unclear. This study examined rates and predictors of post-surgical mental health care in older adults referred for a preoperative evaluation. Methods: Patients aged 75 years or older (n = 1,008) referred to the Geriatrics Service at a comprehensive cancer center were enrolled. Patients underwent elective surgery with a length of stay of 3 days or longer and were followed for at least 30 days after surgery. A comprehensive geriatric assessment (CGA) was administered as part of routine care. Surgical characteristics and post-surgical encounters with social work, psychology, and psychiatry were abstracted from the electronic medical record. Bivariate relationships between demographic and surgical characteristics and the CGA and post-operative receipt of mental health services were examined. Characteristics with significant (p < .01) bivariate relationships were entered into a multivariable regression predicting post-operative mental health service use. Results: One-quarter of the total sample (n = 246, 24.4%) received post-operative mental health services. In multivariable analyses, high distress (Distress Thermometer score≥4; p = .01), poor social support (p = .01), iADL dependence (p = .04), and longer length of stay (p < .001) were associated with receipt of mental health services after controlling for significant sociodemographic and surgical characteristics and CGA variables. Of patients with high distress, poor social support, or iADL dependence, only one-third (29-33%) received mental health care. Conclusions: Distressed older adults and those with low levels of support pre-operatively were more likely to receive mental health services after surgery, controlling for sociodemographic and surgical characteristics. Yet, only one-third of these patients received mental health care. These findings suggest that barriers to translating distress screening into provision of mental health services remain.


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