Evaluation of a Community-Run and General-Practitioner-Supervised Self-Care for Minor Illnesses (CGPSC) Program in a Remote Area in Taiwan.

Although Taiwanese citizens benefit from affordable health care, residents in remote areas extensively rely on unsafe self-care practices because of a lack of easy access to medical services. To improve self-care safety, ten easy-access self-care medical spots (ESCMSs) managed by trained residents were established in two remote villages. This study aimed to assess the impact of ESCMSs on self-care and access to medical services. For a total of six commonly experienced minor illnesses, the average number of illnesses for which residents were confident to perform self-care increased from 2.78 in the pretest to 3.58 in the post-test. ESCMSs were also the first choice when experiencing minor illnesses for 31.25% residents who did not visit a doctor. Residents' personal experience with ESCMSs correlated with their perception of ESCMSs' function. Compared with residents who had no personal experience of using ESCMSs, those who used the ESCMS service were less likely to store medications for minor illnesses at home (51.02% vs. 76.67%). Furthermore, those who attribute the reduced needs for professional help to ESCMSs had used medications for minor illnesses at ESCMSs. These results suggest that establishing ESCMSs is a viable alternative to increase the self-care capacity of residents in remote areas and increase the access to medical resources. Moreover, because residents are less likely to store medication and travel for professional help, ESCMSs could indirectly reduce the risks of self-medication and traffic accidents, respectively. However, caution should be exercised when generalizing these results to more populated areas that also lack medical resources.

Taiwanese depression questionnaire revisit: Factor structure and measurement invariance across genders.

BACKGROUND/PURPOSE: Taiwanese Depression Questionnaire (TDQ) was widely used in Taiwan to measure individuals' proneness to depression. In light of well-established gender differences in the manifestation of depression, TDQ's structure invariance and measurement invariance across genders were examined in this study. METHODS: Data from 2604 adults was analyzed. Exploratory factor analysis was first performed to explore the factor structure. Possible factor structures and the original 2-factor structure were then compared by confirmatory factor analysis (CFA). The best fitting model was tested for measurement invariance across genders using multi-group CFA. RESULTS: EFA revealed 2 possible factor structures and suggested cross-loaded items deletion needed. This resulted in 4 models along with the original 2-factor structure to be tested in the follow-up CFA. Among the 5 models tested, the best-fitting model was the 3-factor solution with 3 cross-loaded items removed. The multi-group CFA performed on this 15-item TDQ revealed that the configural invariance, metrix invariance, and scalar invariance were all supported; partial strict invariance was supported when residual variances of items 1, 9, and 18 were set to vary. CONCLUSION: The 15-item TDQ with a 3-factor structure reflects the manifestations of depression of Taiwanese general population well. Although the results of measurement invariance suggest no gender difference in factor structure, the partial strict invariance suggests that there is gender difference in the amount of variance captured by TDQ. Hence, examining gender differences in the predictive value of different factors regarding health behaviors or medical conditions may bring fruitful results.

Establishing a community-run GP-supervised self-care program for minor illnesses in remote areas in Taiwan: an observational study.

BACKGROUND: We implemented a community-run and GP-supervised self-care for minor illnesses (CGPSC) program in a mountainous area where medical resources for caring for minor illnesses were scarce. In this paper, we reported the residents' experiences and evaluations of this program. METHODS: The CGPSC program was implemented through easy-access self-care medical spots (ESCMSs) that were set up in the community with following services: non-prescription medications for minor illness (MMI) service, materials for caring for minor injuries, pamphlet on self-care for minor illnesses and minor injuries and medical consultation line. Ten selected residents were trained to run the ESCMSs. All services were supervised by the GP in charge. Nine months after the opening of the ESCMSs, a survey was conducted to evaluate residents' reactions to it. RESULTS: Eighty per cent (n = 80) of the respondents were aware of the existence of the ESCMSs, and the MMI service was known to most residents and most utilized by them. Compared to respondents who had not used the MMI service (n = 30), those who had used the service (n = 50) considered the ESCMSs more helpful (90.00% versus 76.67%, P < 0.05) and had greater willingness to seek help from the ESCMS in the future (88.00% versus 56.67%, P < 0.01). CONCLUSIONS: The collaborative efforts of the communities and the medical staff had made the ESCMS a safe, convenient and user-friendly resource to self-care for residents in a rural area. Under the supervision of the GP, trained community residents were able to run the ESCMS smoothly and efficiently.

How well do people recall risk factor test results? Accuracy and bias among cholesterol screening participants.

The authors conducted a community-based cholesterol screening study to examine accuracy of recall for self-relevant health information in long-term autobiographical memory. Adult community residents (N = 496) were recruited to participate in a laboratory-based cholesterol screening and were also provided cholesterol counseling in accordance with national guidelines. Participants were subsequently interviewed 1, 3, or 6 months later to assess their memory for their test results. Participants recalled their exact cholesterol levels inaccurately (38.0% correct) but their cardiovascular risk category comparatively well (88.7% correct). Recall errors showed a systematic bias: Individuals who received the most undesirable test results were most likely to remember their cholesterol scores and cardiovascular risk categories as lower (i.e., healthier) than those actually received. Recall bias was unrelated to age, education, knowledge, self-rated health status, and self-reported efforts to reduce cholesterol. The findings provide evidence that recall of self-relevant health information is susceptible to self-enhancement bias.