Utility of the Health Belief Model in predicting compliance of screening in patients with chronic hepatitis B.

BACKGROUND: Regular surveillance is recommended for patients with chronic hepatitis B, to select candidates for anti-viral therapy and detect early complications. However, factors that determine compliance are not well studied. AIM: To determine the utility of the Health Belief Model in explaining non-compliance, among a group of chronic hepatitis B patients for screening. METHODS: A total of 192 chronic hepatitis B patients who responded to advertisement for free screening took part in a telephonic interview study. Subjects were asked about the five constructs of the Health Belief Model, and factors associated with recent screening were analysed. RESULTS: The mean age of the subjects was 42.1 +/- 0.7 years; 77% white male, and 97% Chinese. About 108 patients (56%) had recent screening. At multivariate analysis, only the ability to remember date of follow-up (OR: 4.37; 95% CI: 2.07-9.17) and the perception of having to wait a long time for venepuncture (OR: 0.38; 95% CI: 0.19-0.79) were significantly associated with recent screening. CONCLUSION: Future public health measures should include improving the logistics of follow-up procedures and providing reminders for screening to improve compliance.

Diagnosing and managing dementia patients. Practice patterns of family physicians.

OBJECTIVE: To examine the practice patterns of family physicians in diagnosing and managing patients with dementia. DESIGN: In-depth structured interviews. SETTING: Metropolitan Toronto family practices. PARTICIPANTS: Twenty family physicians who referred patients to a specialized community psychiatry service for the elderly in the previous year. METHOD: Two vignettes focusing on diagnosis and management issues were developed for the study. Physicians were asked how they would handle the clinical problems presented in the vignettes. Their responses were compared to standardized diagnostic and management protocols. MAIN FINDINGS: Participants were more comfortable with diagnosing dementia than with ongoing management issues, and most physicians were not using standardized cognitive screening protocols. Physicians were more oriented to immediate medical and psychiatric problems than to long-term psychosocial issues. CONCLUSIONS: More attention should be paid to the ongoing educational needs of family physicians with respect to this patient population.