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1.
BMC Health Serv Res ; 21(1): 631, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210296

RESUMO

OBJECTIVES: The average annual healthcare expenditure among elderly patients in Korea is increasing rapidly in indirect healthcare sectors, requiring an understanding of factors related to the use of both formal and informal caregivers. This study analyzed the characteristics of caregiver use and caregiving costs among elderly patients hospitalized due to acute illness or exacerbation of chronic diseases. METHODS: A total of 819 study participants were selected from the 2017 Korea Health Panel Study Data. Replacement costing methods were applied to estimate the hours of informal caregiver assistance received by elderly inpatients. Elderly inpatients' predisposing, enabling, and need factors were studied to identify the relationship between caregiver uses, based on Andersen's behavior model. A two-part model was applied to analyze the factors related to care receipt and to estimate the incremental costs of care. RESULTS: Elderly inpatients who used tertiary hospitals (OR: 2.77, p-value < 0.00) and received financial support (OR: 2.68, p-value < 0.00) were more likely to receive support from a caregiver. However, elderly inpatients living alone were lesser to do so (OR: 0.49, p-value < 0.00). Elderly inpatients with Medicaid insurance (ß:0.54, p-value = 0.02) or financial aid (ß: 0.64, p-value < 0.00) had a statistically positive association with spending more on caregiving costs. Additionally, financial support receivers had incremental costs of $627 in caregiving costs than nonreceivers. CONCLUSIONS: This study presented significant socioenvironmental characteristics of formal and informal caregiver use and the related expenditures. Healthcare management plans that encompass multiple social levels should be implemented to ease the caregiver burden. TRIAL REGISTRATION: Retrospectively registered.


Assuntos
Cuidadores , Pacientes Internados , Idoso , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , República da Coreia
2.
BMC Health Serv Res ; 21(1): 635, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215254

RESUMO

BACKGROUND: Maternal and newborn mortality is high immediately after childbirth and up to 42 days postnatally despite the availability of interventions. Postnatal care is crucial in preventing mortality and improving the health of women and newborns. This prospective cohort study investigated the initiation and utilization of postnatal care at health facilities and explored users' and providers' perspectives on utilization of postnatal care services. METHODS: A sequential explanatory mixed method was used involving women who were followed from the 3rd trimester of pregnancy to 3-4 months postnatally in Northwest, Tanzania. From January to December 2018, a door-to-door survey was conducted 3-4 months postnatally among 1385 of these women. A convenience sample of women and community health workers participated in focus group discussions, and traditional birth attendants and nurses participated in key informant interviews to complement quantitative data. Data analyses were conducted using STATA version 13 and NVIVO version 12. STUDY FINDINGS: Approximately, one half of participants attended postnatal care within 42 days after delivery. Postnatal care seeking within 48 h after delivery was reported by 14.6 % of the participants. Women who attended antenatal care at least four times, delivered at health facilities or experienced delivery-related complications were more likely to seek postnatal care. Limited knowledge on the postnatal care services and obstetric complications after childbirth, and not being scheduled for postnatal care by health providers negatively influenced services uptake. Overwhelming workload and shortages of supplies were reported to hinder the provision of postnatal care services. CONCLUSIONS: Utilization of postnatal care services remains low in this setting as a result of a number of disparate and complex factors that influence women's choices. Provision of effective postnatal care is hindered by lack of supplies, staffing, and inadequate infrastructure. To ensure accessibility and availability of quality services in this setting, both demand and supply sides factors need to be addressed.


Assuntos
Serviços de Saúde Materna , Cuidado Pós-Natal , Serviços de Saúde Comunitária , Parto Obstétrico , Feminino , Acesso aos Serviços de Saúde , Humanos , Recém-Nascido , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Cuidado Pré-Natal , Estudos Prospectivos , Pesquisa Qualitativa , População Rural , Tanzânia
3.
Front Public Health ; 9: 656138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34222170

RESUMO

Healthcare workers are at the frontline of the COVID-19 pandemic and have been identified as a priority target group for COVID-19 vaccines. This study aimed to determine the COVID-19 vaccination intention among nurses and midwives in Cyprus and reveal the influential factors that affected their decision. An Internet-based cross-sectional survey was conducted between December 8 and 28, 2020. Data collection was accomplished using a self-administered questionnaire with questions about socio-demographic characteristics, questions assessing general vaccination-related intentions and behaviors, and the intention to accept COVID-19 vaccination. A sample of 437 responders answered the survey, with 93% being nurses and 7% midwives. A small proportion of the participants would accept a vaccine against COVID-19, while 70% could be qualified as "vaccine hesitant." The main reasons for not receiving the COVID-19 vaccine were concerns about the vaccine's expedited development and fear of side effects. More females, individuals with a larger median age, and a higher number of years of working experience, intended to accept the COVID-19 vaccination, compared with those not intended to accept and undecided groups (p < 0.01). Having a seasonal flu vaccination in the last 5 years, receiving the vaccines recommended for health professionals, and working in the private sector were associated with a higher probability of COVID-19 vaccination acceptance. A considerable rate of nurses and midwives in Cyprus reported unwillingness to receive a COVID-19 vaccine due to vaccine-related concerns. Our findings highlight the need for forthcoming vaccination campaigns and programs to tackle coronavirus vaccine hesitancy barriers to achieve the desirable vaccination coverage.


Assuntos
COVID-19 , Tocologia , Enfermeiras e Enfermeiros , Vacinas contra COVID-19 , Estudos Transversais , Chipre , Feminino , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , SARS-CoV-2 , Vacinação
4.
Medicina (Kaunas) ; 57(6)2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34204614

RESUMO

Background and Objectives The greatest challenge vaccines face is that of acceptance from the general population. Healthcare professionals' (HCPs) recommendations have significant influence on general public vaccination behavior. The aim of this study was to assess the willingness of HCPs to get vaccinated against COVID-19, two weeks before initiation of vaccinations. Materials and Methods: We conducted an anonymous online survey from 11-15 December 2020 among HCPs by emails delivered from the local medical and nursing stuff associations. Results: The 71.1% of 656 HCPs intended to accept vaccination, 5.9% did not and 23% were still undecided. The acceptance rate was higher in physicians (76.5%) and significantly lower in nurses (48.3%). Most of the responders who intended to accept vaccination were males (p = 0.01), physicians (p = 0.001), older (p = 0.02), married (p = 0.054) with children (p = 0.001), and had treated patients with COVID-19 (p < 0.001). In the multivariate logistic regression, the predictors of HCPs willingness to get vaccinated were parenthood (OR = 4.19, p = 0.003), being a physician (OR = 2.79, p = 0.04), and treating confirmed/suspected COVID-19 patients (OR = 2.87, p = 0.036). Conclusions: Low vaccination acceptance rate was found especially in nurses, and as this may have a negative impact in the vaccination compliance of the general public, interventional educational programs to enhance vaccination are crucial.


Assuntos
COVID-19 , Vacinas contra Influenza , Criança , Estudos Transversais , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , SARS-CoV-2 , Vacinação
5.
Medicina (Kaunas) ; 57(6)2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: covidwho-1270078

RESUMO

Background and Objectives The greatest challenge vaccines face is that of acceptance from the general population. Healthcare professionals' (HCPs) recommendations have significant influence on general public vaccination behavior. The aim of this study was to assess the willingness of HCPs to get vaccinated against COVID-19, two weeks before initiation of vaccinations. Materials and Methods: We conducted an anonymous online survey from 11-15 December 2020 among HCPs by emails delivered from the local medical and nursing stuff associations. Results: The 71.1% of 656 HCPs intended to accept vaccination, 5.9% did not and 23% were still undecided. The acceptance rate was higher in physicians (76.5%) and significantly lower in nurses (48.3%). Most of the responders who intended to accept vaccination were males (p = 0.01), physicians (p = 0.001), older (p = 0.02), married (p = 0.054) with children (p = 0.001), and had treated patients with COVID-19 (p < 0.001). In the multivariate logistic regression, the predictors of HCPs willingness to get vaccinated were parenthood (OR = 4.19, p = 0.003), being a physician (OR = 2.79, p = 0.04), and treating confirmed/suspected COVID-19 patients (OR = 2.87, p = 0.036). Conclusions: Low vaccination acceptance rate was found especially in nurses, and as this may have a negative impact in the vaccination compliance of the general public, interventional educational programs to enhance vaccination are crucial.


Assuntos
COVID-19 , Vacinas contra Influenza , Criança , Estudos Transversais , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , SARS-CoV-2 , Vacinação
6.
BMC Infect Dis ; 21(1): 641, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34217245

RESUMO

BACKGROUND: Recent approaches to TB control have focused on identifying and treating active cases to halt further transmission. Patients with TB symptoms often delay to seek care, get appropriate diagnosis, and initiate effective treatment. These delays are partly influenced by whom the patients contact within their community network. We aimed to evaluate the community drivers of diagnostic delay in an urban setting in Uganda. METHODS: In this study we analyze data from a retrospective cohort of 194 TB patients in Kampala, Uganda. We characterized the patterns of contacts made by patients seeking care for TB symptoms. The main outcome of interest was total community contact delay, defined as the time patients spent seeking care before visiting a provider capable of diagnosing TB. RESULTS: Visits to health providers without access to appropriate diagnostic services accounted for 56% of contacts made by cohort members, and were significantly associated with community contact delay, as were symptoms common to other prevalent illnesses, such as bone and joint pain. CONCLUSIONS: Education programs aimed at primary care providers, as well as other community members, may benefit case identification, by informing them of rarer symptoms of TB, potential for co-infections of TB and other prevalent diseases, and the availability of diagnostic services.


Assuntos
Diagnóstico Tardio , Acesso aos Serviços de Saúde/estatística & dados numéricos , Tempo para o Tratamento/estatística & dados numéricos , Tuberculose/diagnóstico , Tuberculose/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Saúde Pública , Estudos Retrospectivos , Uganda , Adulto Jovem
7.
BMC Health Serv Res ; 21(1): 670, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238320

RESUMO

BACKGROUND: Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers' healthcare-seeking behavior for their under five children. METHODS: The study used the Ethiopian Demographic and Health Surveys (EDHS) data. The EDHS is a cross sectional survey conducted in 2016 on a nationally representative sample of 10,641 respondents. The main determinants of care-seeking during diarrhea and acute respiratory infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design. RESULTS: Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of 2 weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for literate fathers compared to those with no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced Intimate Partner Violence (IPV) violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI. CONCLUSIONS: The findings call for more coordinated efforts to ensure equitable access to health care services focusing on mothers living in deprived household environment. Strengthening partnerships with public facilities, private health care practitioners, and community-based organizations in rural areas would help further improve access to the services.


Assuntos
Mães , Aceitação pelo Paciente de Cuidados de Saúde , Criança , Estudos Transversais , Diarreia/epidemiologia , Diarreia/terapia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Morbidade
9.
MMWR Morb Mortal Wkly Rep ; 70(28): 997-1003, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34264908

RESUMO

On May 10, 2021, the Food and Drug Administration (FDA) expanded its Emergency Use Authorization for the Pfizer-BioNTech COVID-19 vaccine to include adolescents aged 12-15 years; this authorization was followed by interim recommendations from the Advisory Committee on Immunization Practices (ACIP) for the vaccine among this age group (1). Using data from nonprobability-based Internet panel surveys administered by the Healthcare and Public Perceptions of Immunizations (HaPPI) Survey Collaborative, the acceptability of adolescent COVID-19 vaccination and self-reported factors increasing vaccination intent were assessed among independently recruited samples of 985 adolescents aged 13-17 years and 1,022 parents and guardians (parents) of adolescents aged 12-17 years during April 15-April 23, 2021, prior to vaccine authorization for this age group. Approximately one quarter (27.6%) of parents whose adolescents were already vaccine-eligible (i.e., aged 16-17 years) reported their adolescent had received ≥1 COVID-19 vaccine dose, similar to the proportion reported by vaccine-eligible adolescents aged 16-17 years (26.1%). However, vaccine receipt reported by parents of adolescents differed across demographic groups; parents identifying as female or Hispanic, or who had an education lower than a bachelor's degree reported the lowest adolescent COVID-19 vaccination receipt. Among parents of unvaccinated adolescents aged 12-17 years, 55.5% reported they would "definitely" or "probably" have their adolescent receive a COVID-19 vaccination. Among unvaccinated adolescents aged 13-17 years, 51.7% reported they would "definitely" or "probably" receive a COVID-19 vaccination. Obtaining more information about adolescent COVID-19 vaccine safety and efficacy, as well as school COVID-19 vaccination requirements, were the most commonly reported factors that would increase vaccination intentions among both parents and adolescents. Federal, state, and local health officials and primary care professionals were the most trusted sources of COVID-19 vaccine information among both groups. Efforts focusing on clearly communicating to the public the benefits and safety of COVID-19 vaccination for adolescents, particularly by health care professionals, could help increase confidence in adolescent COVID-19 vaccine and vaccination coverage.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Vacinação/psicologia , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Criança , Informação de Saúde ao Consumidor , Feminino , Humanos , Intenção , Masculino , Estados Unidos/epidemiologia
10.
Front Public Health ; 9: 656138, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1295717

RESUMO

Healthcare workers are at the frontline of the COVID-19 pandemic and have been identified as a priority target group for COVID-19 vaccines. This study aimed to determine the COVID-19 vaccination intention among nurses and midwives in Cyprus and reveal the influential factors that affected their decision. An Internet-based cross-sectional survey was conducted between December 8 and 28, 2020. Data collection was accomplished using a self-administered questionnaire with questions about socio-demographic characteristics, questions assessing general vaccination-related intentions and behaviors, and the intention to accept COVID-19 vaccination. A sample of 437 responders answered the survey, with 93% being nurses and 7% midwives. A small proportion of the participants would accept a vaccine against COVID-19, while 70% could be qualified as "vaccine hesitant." The main reasons for not receiving the COVID-19 vaccine were concerns about the vaccine's expedited development and fear of side effects. More females, individuals with a larger median age, and a higher number of years of working experience, intended to accept the COVID-19 vaccination, compared with those not intended to accept and undecided groups (p < 0.01). Having a seasonal flu vaccination in the last 5 years, receiving the vaccines recommended for health professionals, and working in the private sector were associated with a higher probability of COVID-19 vaccination acceptance. A considerable rate of nurses and midwives in Cyprus reported unwillingness to receive a COVID-19 vaccine due to vaccine-related concerns. Our findings highlight the need for forthcoming vaccination campaigns and programs to tackle coronavirus vaccine hesitancy barriers to achieve the desirable vaccination coverage.


Assuntos
COVID-19 , Tocologia , Enfermeiras e Enfermeiros , Vacinas contra COVID-19 , Estudos Transversais , Chipre , Feminino , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , SARS-CoV-2 , Vacinação
11.
Viruses ; 13(7)2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34206645

RESUMO

As pregnant women are at high risk of severe SARS-CoV-2 infection and COVID-19 vaccines are available in Switzerland, this study aimed to assess the willingness of Swiss pregnant and breastfeeding women to become vaccinated. Through a cross-sectional online study conducted after the first pandemic wave, vaccination practices and willingness to become vaccinated against SARS-CoV-2 if a vaccine was available were evaluated through binary, multi-choice, and open-ended questions. Factors associated with vaccine willingness were evaluated through univariable and multivariable analysis. A total of 1551 women responded to questions related to the primary outcome. Only 29.7% (153/515) of pregnant and 38.6% (400/1036) of breastfeeding women were willing to get vaccinated against SARS-CoV-2 if a vaccine had been available during the first wave. Positive predictors associated with SARS-CoV-2 vaccine acceptance were an age older than 40 years, a higher educational level, history of influenza vaccination within the previous year, having an obstetrician as the primary healthcare practitioner, and being in their third trimester of pregnancy. After the first pandemic wave, Switzerland had a low SARS-CoV-2 vaccination acceptance rate, emphasizing the need to identify and reduce barriers for immunization in pregnant and breastfeeding women, particularly among the youngest and those with a lower educational level.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , COVID-19/epidemiologia , COVID-19/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vacinação/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Inquéritos e Questionários , Suíça/epidemiologia , Vacinação/estatística & dados numéricos
12.
Br J Community Nurs ; 26(7): 338-343, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34232715

RESUMO

The success of a vaccination programme depends upon its coverage so that it provides herd immunity. Vaccine hesitancy has the potential to undermine a vaccine programme. Evidence suggests that some strategies are more effective in promoting vaccination uptake. Community nurses should help in the promotion of vaccination uptake using evidence-based interventions and through 'Making Every Contact Count'.


Assuntos
Vacinas contra COVID-19 , Enfermagem em Saúde Comunitária , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Programas de Imunização/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Humanos
13.
Reprod Health ; 18(1): 145, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229709

RESUMO

BACKGROUND: Maternal mortality is an important public health problem in low-income countries. Delays in reaching health facilities and insufficient health care professionals call for innovative community-level solutions. There is limited evidence on the role of community health workers in the management of pregnancy complications. This study aimed to describe the feasibility of task-sharing the initial screening and initiation of obstetric emergency care for pre-eclampsia/eclampsia from the primary healthcare providers to community health workers in Mozambique and document healthcare facility preparedness to respond to referrals. METHOD: The study took place in Maputo and Gaza Provinces in southern Mozambique and aimed to inform the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial. This was a mixed-methods study. The quantitative data was collected through self-administered questionnaires completed by community health workers and a health facility survey; this data was analysed using Stata v13. The qualitative data was collected through focus group discussions and in-depth interviews with various community groups, health care providers, and policymakers. All discussions were audio-recorded and transcribed verbatim prior to thematic analysis using QSR NVivo 10. Data collection was complemented by reviewing existing documents regarding maternal health and community health worker policies, guidelines, reports and manuals. RESULTS: Community health workers in Mozambique were trained to identify the basic danger signs of pregnancy; however, they have not been trained to manage obstetric emergencies. Furthermore, barriers at health facilities were identified, including lack of equipment, shortage of supervisors, and irregular drug availability. All primary and the majority of secondary-level facilities (57%) do not provide blood transfusions or have surgical capacity, and thus such cases must be referred to the tertiary-level. Although most healthcare facilities (96%) had access to an ambulance for referrals, no transport was available from the community to the healthcare facility. CONCLUSIONS: This study showed that task-sharing for screening and pre-referral management of pre-eclampsia and eclampsia were deemed feasible and acceptable at the community-level, but an effort should be in place to address challenges at the health system level.


Assuntos
Serviços de Saúde Comunitária/normas , Agentes Comunitários de Saúde/psicologia , Tratamento de Emergência/normas , Conhecimentos, Atitudes e Prática em Saúde , Pré-Eclâmpsia , Adulto , Competência Clínica , Gerenciamento Clínico , Estudos de Viabilidade , Feminino , Humanos , Mortalidade Materna , Moçambique , Aceitação pelo Paciente de Cuidados de Saúde , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/terapia , Gravidez , Cuidado Pré-Natal , Encaminhamento e Consulta
14.
Reprod Health ; 18(1): 146, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229710

RESUMO

BACKGROUND: Women's satisfaction with childbirth experience is considered as one of the quality indicators of the maternity services across the world. However, there is no guideline for improving the experience of childbirth in Iran that is suitable for women with different cultural, economic, and social statuses. The aim of this study is to make recommendations for practice and propose a clinical guideline for improving the experience of women with vaginal births. METHODS/DESIGN: The study design was a mixed method study with a sequential explanatory approach consisting of three phases. The first phase of the study was a cross-sectional study to identify the predictors of traumatic vaginal childbirth experience among 800 primiparous women from Tabriz health centers who had vaginal birth. Data collection tools in this phase were Childbirth Experience Questionnaire (CEQ) and Support and Control in Birth (SCIB). Both tools were validated for Farsi language. The second phase was a qualitative study with 17 in-depth individual interviews among women who took part in the first phase to better understand their reasons that influenced their childbirth experience either positively or negatively. The third phase of the study was to develop recommendations for a proposed clinical guideline through a Delphi study where maternal health experts were selected and invited to take part in the panel. They first rated the proposed recommendations individually and provided written responses on their own agreement or disagreement with each statement in terms of its impact on childbirth experience, feasibility, acceptability, and cost-effectiveness. After three confirmation rounds, the final conscience was reached by the panel members. RESULTS: The results of the quantitative phase showed that the probability of negative experience of childbirth was increased when physical exercise was not implemented during pregnancy, lacking pain relief options, having fear of childbirth, lacking skin to skin contact with the newborn and being unable to initiate breastfeeding in the first hour after birth (P < 0.05). The analysis of qualitative data revealed 13 major theme categories which were related to women's sense of internal control, external control and support. In the third phase of the study, culturally appropriate recommendations were made and an evidence-based clinical guideline was proposed. The proposed guideline was based on the combination of the quantitative and qualitative phases, a review of the literature, and the opinions of Iranian experts using the Delphi technique. CONCLUSION: Given the high prevalence of negative childbirth experience among Iranian primiparous women, the present study may be of great interest for managers, leaders, policymakers, and care providers to improve the quality of the maternity services. However, further studies are required to translate the recommendations into practice and identify enablers and barriers during the implementation of the proposed guideline. To adopt the recommendations at national level, there is a need to further studies to assess the effectiveness of the proposed guideline within different communities across the region and the country.


Assuntos
Parto Obstétrico/psicologia , Parto/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente , Mulheres/psicologia , Estudos Transversais , Parto Obstétrico/métodos , Feminino , Humanos , Recém-Nascido , Irã (Geográfico) , Parto/etnologia , Gravidez , Relações Profissional-Paciente , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Confiança
15.
Am J Mens Health ; 15(4): 15579883211030021, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34229530

RESUMO

The COVID-19 pandemic continues to be a source of stress and have important mental health implications for all persons but may have unique implications for men. In addition to the risk of contracting and dying from COVID-19, the rising COVID-19 death toll, ongoing economic uncertainty, loneliness from social distancing, and other changes to our lifestyles make up the perfect recipe for a decline in mental health. In June 2020, men reported slightly lower rates of anxiety than women, but had higher rates of depressive symptoms and suicidal ideation. As of September 2020, men sought mental health care at a higher rate than women for family and relationships, with year-over-year visits up 5.5 times and total virtual mental health care visits monthly growth in 2020 was up 79% since January. Because men are not a homogeneous group, it is important to implement strategies for groups of men that may have particularly unique needs. In this paper, we discuss considerations for intervening in men's mental health during and in response to the COVID-19 pandemic, including current technology-based cyberpsychology options.


Assuntos
COVID-19/psicologia , Comportamento de Busca de Ajuda , Saúde do Homem/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Ansiedade/psicologia , Depressão/psicologia , Humanos , Solidão/psicologia , Masculino , Saúde Mental/estatística & dados numéricos , Ideação Suicida
17.
Rev Esp Salud Publica ; 952021 Jul 28.
Artigo em Espanhol | MEDLINE | ID: mdl-34267176

RESUMO

OBJECTIVE: The success of policies to eradicate COVID-19 depends on the acceptance of vaccines among the population. This paper measures the influence on the intention to get vaccinated of three usual variables in studies on consumer behavior: the perception of the efficiency and risk of the vaccine and the social influence. METHODS: It was used a survey of 600 residents in Spain that was answered during September 2020 has been used. That survey was conveniently stratified by age and monthly income. The impact of the explanatory variables on the intention to use the vaccine was measured with generalized linear models: logistic regression and truncated negative binomial regression. Contro variables were gender, age and monthly income. RESULTS: We have observed a positive (negative) influence of the variables efficacy perception and social influence (perception of risk), i.e. a ratio of rate use above (below) 1 that is statistically significant (p<0.01 in the case of the first two variables and p<0.05 in the third). Their importance follows the order described above. Neither gender nor age were significant in the intention to get vaccinated, but the income level was. We identified that at the highest income levels there was a greater propensity to reject the vaccine (p<0.1). CONCLUSIONS: The results may be useful to guide the information policy that health authorities should carry out in order to induce the population to use the SARS-CoV-2 vaccine.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Vacinação/psicologia , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Inquéritos e Questionários , Adulto Jovem
18.
Front Public Health ; 9: 616456, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34195167

RESUMO

Introduction: Cervical cancer, a major consequence of persistent HPV infection, is the third most common cancer in women worldwide and has claimed around 311,000 women lives in 2018. The majority of these deaths took place in low- and middle-income countries (LMICs). In LMICs, where cervical cancer screening coverage is low, the HPV vaccine is a promising tool for preventing HPV infections and, thus, averting cervical cancer cases. In Indonesia, cervical cancer is the second most common cancer and HPV vaccination demonstration programs are underway in several provinces, but the HPV vaccine has not yet been introduced nationally. Since students are an important source of information for the community, and medical and nursing students are the future healthcare professionals, this study explored the knowledge, attitude, and acceptability of the HPV vaccine among University students in Indonesia. Methodology: A self-administered online questionnaire was used to assess the knowledge, attitude, and willingness of University students toward HPV vaccination. Result: A total of 433 students from Medical, Nursing, Social Sciences, and other faculties participated in the survey. It was identified that over 90% of the students were aware of cervical cancer and HPV, but only 68% knew about the HPV vaccine before participating in the study. Despite an average knowledge on the HPV vaccine, the students showed a strong willingness to receive the vaccine (95.8% acceptance rate). They believed that the HPV vaccine is safe and effective and that it will protect against HPV infection. The high cost and the lack of adequate information flow on HPV-related topics have been identified as potential barriers to the adoption of the HPV vaccine in Indonesia. Conclusion: Despite a high willingness for HPV vaccine uptake among students, there is a need to provide education on HPV vaccine-related topics to Indonesian students through awareness and training programs and improving the academic curriculum on vaccination for the long-term sustainability of the HPV vaccination program.


Assuntos
Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Indonésia/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Universidades , Neoplasias do Colo do Útero/prevenção & controle , Vacinação
19.
BMJ Open ; 11(6): e043940, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34083327

RESUMO

OBJECTIVES: Relative to the attention given to improving the measurement of adequacy of antenatal care (ANC) in South Asian (SA) region, the influence of women's empowerment and socioeconomic status (WESES) on adequate ANC services has hardly received any attention. This study aimed to investigate the present scenario of adequacy of ANC in SA and how its adequacy was associated with WESES. SETTING AND PARTICIPANTS: Using the Demographic and Health Survey data set of five SA countries, that is, Afghanistan, Bangladesh, India, Nepal and Pakistan, 48 107 women were selected in this study who received at least one ANC component and had at least one live birth in the 3 or 5 years preceding the survey. ANALYSIS: Multilevel logistic regression models were used to investigate the relationship between adequacy of ANC and WESES. RESULTS: Only 30% women received adequate ANC in SA, ranging from 8.4% (95% CI 7.1% to 9.9%) in Afghanistan to 39.8% (95% CI 37.4% to 42.2%) in Nepal. The poor utilisation of adequate ANC services was most prevalent among the women residing in rural areas and that of poor families as well as low empowerment status in SA countries. Different levels of WESES, that is, highly empowered but poor (adjusted OR (AOR): 1.33; 95% CI 1.18 to 1.49), lowly empowered but rich (AOR: 2.07; 95% CI 1.84 to 2.32) and highly empowered and rich women (AOR: 3.07; 95% CI 2.75 to 3.43), showed significant positive association with adequate ANC services than the poor and low empowered women, after adjusting the potential covariates. CONCLUSION: As unsatisfactory level of adequate ANC services has been observed in SA region, this study suggests a nationwide comprehensive improvement of women's empowerment status as well as establishment of necessary healthcare centres in remote areas is essential to ensure long-term and sustainable adequacy of ANC services.


Assuntos
Cuidado Pré-Natal , Classe Social , Afeganistão , Bangladesh , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Nepal , Paquistão , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Fatores Socioeconômicos
20.
BMC Public Health ; 21(1): 1075, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090402

RESUMO

BACKGROUND: Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. METHODS: Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. RESULTS: Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. CONCLUSION: The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons.


Assuntos
Malária , Animais , Feminino , Febre/epidemiologia , Febre/etiologia , Febre/terapia , Humanos , Malária/tratamento farmacológico , Malária/epidemiologia , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Autorrelato , Tanzânia/epidemiologia
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