ABSTRACT
This study sought to replicate Parslow and Jorm's (Aust N Z J Psychiatry 34(6): 997-1008, 2000) research on need, enabling and predisposing factors as predictors of mental health service use, with the addition of childhood trauma as a predisposing factor. It utilised a non-treatment seeking epidemiological sample of Australian adults (N = 822) to examine 25 variables covering psychiatric disorder, socio-demographics, physical health problems, and childhood trauma as predictors of mental health visits to general practitioners (GP's), mental health specialists and non-mental health specialists. A consistent multivariate predictor of mental health visits to all types of professionals was psychological distress. Presence of an affective disorder, age, and number of health problems were additional predictors of visiting a GP. Being female, divorced, and exposure to childhood trauma predicted use of a mental health specialist, while rural living was associated with lower use of these services. Results highlight the importance of general psychological distress and need factors in seeking help for mental health, and reinforce the lifelong disadvantage arising from adverse childhood experiences and the need to address these issues in adult mental health services.
Subject(s)
Mental Health Services/statistics & numerical data , Patient Acceptance of Health Care/psychology , Rural Population/statistics & numerical data , Stress Disorders, Traumatic/epidemiology , Adolescent , Adult , Australia/epidemiology , Case-Control Studies , Child , Child, Preschool , Disasters , Female , Follow-Up Studies , Humans , Logistic Models , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Socioeconomic Factors , Stress Disorders, Traumatic/diagnosis , Stress Disorders, Traumatic/psychology , Surveys and Questionnaires , Survivors/statistics & numerical dataABSTRACT
Health care is continuously undergoing evolutionary changes. These changes have been very dramatic for the end users. Instead of simple physician office visits and lengthy hospital stays, we are now faced with short hospital stays, office visits to different specialty providers, and an array of choices around them. With the present highway of choices between illness and wellness, it is important for transitions between these two to be affordable, advantageous to patients, and uncomplicated. This article discusses the choices patients and health care providers must make as the number of care options increase along with the risks and benefits.
Subject(s)
Continuity of Patient Care/trends , Nursing Process , Health Personnel , Humans , United StatesABSTRACT
Computer-simulated microworlds can provide a controlled method for investigating concepts related to naturalistic decision making (NDM). However, the extent to which these tools can be used to generate meaningful outcomes is unknown. The current study used a microworld called Networked Fire Chief (NFC) to explore the range of skills and knowledge acquired as participants gained practice on the program. The complexity of the NFC NDM environment was also explored. Twenty participants each completed 20 equivalent 5-min scenarios on NFC. Interview data, behavioral data and performance scores were collected across the trials. Results confirmed that NFC provides an environment that promotes appropriate perceptual-cognitive processing for NDM. However, performance improved to only a small extent across the 20 trials in four performance areas: speed, accuracy, efficiency and planning. In addition, the number of personal and situational factors to be considered when decision making on NFC was not comparable with real-world NDM environments. Overall, results indicated that the use of microworlds for research should be regulated by an understanding of the limitations of their applicability.
Subject(s)
Computer Simulation , Decision Making , Psychology, Experimental/statistics & numerical data , User-Computer Interface , Adult , Cognition , Female , Humans , Male , Psychology, Experimental/instrumentationABSTRACT
South Florida is home to a highly transient population of approximately 145,000 men who have sex with men (MSM) and annually hosts over 1.8 million gay and bisexual visitors. To develop more effective interventions for HIV/sexually transmitted infections (STI) prevention in this setting, we conducted a cross-sectional study of recreational drug use and risky sexual behaviors among MSM. A standardized, self-administered questionnaire, reviewed and approved by a university Institutional Review Board, was offered to men 18 years of age and older who reported ever having sex with a man. Men were approached on weekends in five diverse locations in Miami-Dade County and five in Broward County in winter 2004. An honorarium of $10 was offered to those who completed and returned a questionnaire. Of 407 participants, 115 men (28%) lived in Miami-Dade, 147 (36%) lived in Broward, 46 (11%) lived in another county in south Florida, and 99 (24%) lived elsewhere. Overall, 32% reported using one or more "club drugs" in the past year. Club drug use was highly associated with unprotected anal intercourse (UAI) (P < .001). MSM residing outside of south Florida were more likely than local residents to report using cocaine and ketamine and engaging in unprotected receptive anal intercourse (URAI) in the past month (P = .03). Tourists may be even more likely than residents to engage in risky sexual behaviors and use certain recreational drugs. Interventions must be developed, implemented, and evaluated that take into account the unique characteristics of international resort areas.