Actual Use Of Services Research Articles

Bulimic Eating Disorders in Primary Care: Hidden Morbidity Still?

The current study examined the features of women with bulimic-type eating disorders (n = 24) attending primary care in two smaller urban regions of the USA. The assessment included measures of eating disorder psychopathology, medical comorbidity, impairment in role functioning, potential barriers to treatment and actual use of health services. Eating disorders, primarily variants of bulimia nervosa and binge eating disorder not meeting formal diagnostic criteria, were associated with marked impairment in psychosocial functioning. Although two-thirds of participants recognized a problem with their eating, less than 40% had ever sought treatment from a health professional for an eating or weight problem and only one in ten had sought such treatment from a mental health specialist. Only one-third had ever been asked about problems with eating by a primary care practitioner or other health professional. However, more than 80% had sought treatment from a health professional for symptoms of anxiety or depression. Most reported some degree of discomfort in discussing eating problems with others, and half reported that they would not be truthful about such problems if asked. Having an eating disorder was associated with several chronic medical conditions, including joint pain, gastrointestinal problems and fatigue. Although the small sample size limits any firm conclusions, the findings suggest that the health burden of bulimic-type eating disorders is substantial but remains largely hidden. Efforts may be needed to improve the eating disorders "mental health literacy" of both patients and primary care practitioners in order to facilitate early, appropriate intervention.

Race-Ethnicity as a Predictor of Attitudes Toward Mental Health Treatment Seeking

Race-Ethnicity as a Predictor of Attitudes Toward Mental Health Treatment Seeking

Race-Ethnicity as a Predictor of Attitudes Toward Mental Health Treatment Seeking

Previous research on mental health disparities shows that persons from racial-ethnic minority groups have less access to mental health care, engage in less treatment, and receive poorer-quality treatment than non-Hispanic whites. Attitudes and beliefs about mental health treatment were examined to determine whether they contribute to these disparities. Data from the National Comorbidity Survey Replication (NCS-R) were analyzed to determine attitudes toward treatment-seeking behavior among people of non-Hispanic white, African-American, and Hispanic or Latino race-ethnicity. Additional sociodemographic variables were examined in relation to attitudes and beliefs toward treatment. African-American race-ethnicity was a significant independent predictor of greater reported willingness to seek treatment and lesser reported embarrassment if others found out about being in treatment. These findings persisted when analyses adjusted for socioeconomic variables. Hispanic or Latino race-ethnicity also was associated with an increased likelihood of willingness to seek professional help and lesser embarrassment if others found out, but these differences did not persist after adjustment for the effects of socioeconomic variables. Contrary to the initial hypothesis, African Americans and Hispanics or Latinos may have more positive attitudes toward mental health treatment seeking than non-Hispanic whites. To improve access to mental health services among racial-ethnic minority groups, it is crucial to better understand a broader array of individual-, provider-, and system-level factors that may create barriers to care.

Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study

Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study

Perceived Need for Mental Health Care and Service Use Among Adults in Western Europe: Results of the ESEMeD Project

Perceived Need for Mental Health Care and Service Use Among Adults in Western Europe: Results of the ESEMeD Project

An empirical study of the factors affecting social network service use

Social network services are emerging as a promising IT-based business, with some services already being provided commercially such as Facebook, Cyworld and Xiaonei. However, it is not yet clear which potential audience groups will be key social network service participants. Moreover, the process showing how an individual actually decides to start using a social network service may be somewhat different from current web-based community services. Hence, the aims of this paper are twofold. First, we empirically examine how individual characteristics affect actual user acceptance of social network services. To examine these individual characteristics, we apply a Technology Acceptance Model (TAM) to construct an amended model that focuses on three individual differences: social identity, altruism and telepresence, and one perceived construct: the perceived encouragement, imported from psychology-based research. Next, we examine if the users’ perception to see a target social network service as human relationship-oriented service or as a task-oriented service could be a moderator between perceived constructs and actual use. As a result, we discover that the perceived encouragement and perceived orientation are significant constructs that affect actual use of social network services.

Potential and Actual Accessibility to Hospital and Hospital Services in Northeast Florida

This paper attempts to answer several questions addressing the provision of health care services in the Jacksonville, Florida MSA. Previous literature in the field of medical geography has focused on describing potential accessibility to hospitals and healthcare services, but this study also models actual use of such services by using a hospital patient database. Findings from a GIS-based analysis using ESRI ArcGIS and the Business Analyst extension suggests that distance to the nearest hospital is not the best measure of access to hospital care because of the lack of consideration of hospital capacity. This study demonstrates that health services delivery can be better understood and planned when the potential accessibilities to services and the actual utilization of such services are jointly considered.

Family Influence on Caregiver Resistance, Efficacy, and Use of Services in Family Elder Care

This research investigated how resistance to use of services attributed to family members and primary caregiver self-efficacy and resistance influenced actual use of services. Data were analyzed from questionnaires completed by 224 persons engaged in informal elder care in the community. Tests of 6 hypotheses revealed that family influence on caregivers had a consistent, important influence on behavior and views of caregivers. Family resistance to use of formal services framed caregivers' feelings, preferences, and decisions ranging from their own perceived self-efficacy to actual obtainment of help outside the family. Professionals must include family members in their dialogue with primary caregivers about their plans for elder care. Suggestions for interventions to better understand family and caregiver resistance are discussed.

Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders

ObjectiveTo investigate the prevailing attitudes towards mental health help-seeking in Europe, their correlates, and whether these attitudes are associated with actual service use for mental health problems.MethodData were derived from the European Study of Epidemiology of Mental Disorders, a survey representative of the adult population of six countries: Belgium, France, Germany, Italy, the Netherlands and Spain (n = 8,796). The World Mental Health Composite International Diagnostic Interview was used to assess attitudes and DSM-IV diagnoses. The attitudes referred to beliefs that the respondents would seek professional help when faced with a serious emotional problem, would feel comfortable talking about personal problems with a professional, would not be embarrassed if friends knew about the professional help, and respondents’ perceived effectiveness of mental health care.ResultsAlmost a third of the respondents held the view that professional care was worse than or equal to no help when faced with serious emotional problems. Female gender, being younger than 65 years of age, high income, living in Spain or Italy, presence of mood disorder and previous service use were associated with at least two of the four assessed attitudes towards mental health help-seeking. All four attitudes were significantly associated with mental health care use, also after adjustment for previous service use.ConclusionThe low perceived effectiveness of professional care calls for serious action aiming to improve the visibility and credibility of the mental health care sector.

Healthcare services accessibility of children in the USA

The increase in the number of children without access to healthcare services is an increasingly urgent issue in the United States. By using data from the Community Tracking Study Household Survey 1996 to 1997, we focus this study on the determinants that cause for the widening gap of healthcare service accessibility among children, 18 years and under, in the USA. Our empirical results suggest that factors such as the out-of-pocket price of healthcare services, household income, years of education by parent (or guardian), health insurance coverage, access to healthcare provider (availability of regular provider, obtaining an appointment, and travelling time) and provider–patient interaction strongly determine the actual use of outpatient services by children as realized access (i.e. accessibility).

Health Services Research

The discipline of health services research, often loosely referred to as outcomes research, is primarily focused on the study of access to care, costs of care, and quality of care. Access to care includes everything that facilitates or impedes the actual use of medical services. Costs of care include financial and nonfinancial payments by insurers and individuals for medical services as well as the opportunity cost of lost wages and the societal cost of decreased productivity. Quality of care encompasses elements of the structure, process, and outcome of medical care.

T11-O-05 MODI DI: a national health survey of gay, lesbian, bisexual people in Italy

Objective The research project MODI DI was funded by the Italian National Health Institute (ISS) and it is the first large-scale study on the health of lesbian, bisexual and gay people in Italy. Design and method: Through widely disseminated questionnaires, statistical data were collected on a number of major themes: health status, health-compromising and protective behaviores (smoking, alcohol and drug use, sexual risk taking), coming out and social resources, perceived discrimination in the health services, HIV-status and HIV-related expectancies and skills. 2084 women and 4690 men answered to the questionnaire. The majority lived in the North of the country, most of these participants were young, with an average age of 31. Results Coming out and discolsure to significant others of the respondents is linked to age and geographic place of residence.: the most difficult situation to “come out” is undoubtedly the work environment; discolsure of sexual orientation in the family of origin is related to relational status. The majority of subjects have not disclosed their sexual orientation to their general practitioners and to gynaecologist. Expection of discrimination is a predictor of actual use of health services. Lesbian, bisexual and gay people reported high prevalence of smoking and alcohol use. As regards men's health, 5% reported to be HIV-positive and almost one third not tested; almost one third reported unsafe anal intercourse. Psychosocial predictors of testing and safer sex are presented. Implications for health promotion programs are discussed.

Factors Influencing Perceptions of Need for and Decisions to Solicit Child Mental Health Services by Parents of 9–12 Year-Old Korean Children

As children with emotional or behavioral problems often fail to receive the treatment available to them, this study examined (1) the degree of perceived need (PN) among Korean parents regarding mental health services for their children, (2) the factors associated with such perceptions, (3) the degree to which Korean parents actually engage mental health services for their children, and (4) the factors associated with such use. To determine the degrees of PN and actual use, 1,058 children aged between 9 and 12 years were asked to complete the Children's Depression Inventory, while their parents completed the Child Behavior Checklist. About 11.4% of the parents demonstrated PN, compared to 2.7% who actually engaged child mental health services. While most of the CBCL factors were associated with PN, the child's self-report significantly affected the perception as well. The attention problem score in the CBCL was the only factor that strongly corresponded to the actual use of services in Korea, a country where academic achievement is considered paramount, which suggests that cultural forces may play a powerful role in determining parents' decisions regarding child mental health care.

Americans' Attitudes Toward Mental Health Treatment Seeking: 1990-2003

Americans' Attitudes Toward Mental Health Treatment Seeking: 1990-2003

Demographic Characteristics of Individuals Who Received Project Liberty Crisis Counseling Services

Demographic Characteristics of Individuals Who Received Project Liberty Crisis Counseling Services

Improving Older Adults' Functional Ability Through Service Use in a Home Care Program in Hong Kong

Objective: Despite past findings about the contribution of home care services to older users’ functional ability, the effective processes and components of the services are not transparent. Such processes appear to rely on the actual use of component services of the home care program. Method: The study gathered 116 observations during 2 years concerning 49 home care service users in Hong Kong. Results: The study shows that an older user maintained better functional ability with a longer time of using a home care program in Hong Kong using the service. The time effect, in turn, was primarily due to the increased use of seven services provided by the program. Among the service components, the home-nursing services generated a unique contribution to the user's functional ability, with its prior score controlled. Conclusions: Multidisciplinary services under case management underpin an effective home care program.

Need for and actual use of mental health service by adolescents in the child welfare system

Although foster youth are at increased risk of mental illness, little is known about need for and actual use of mental health services by adolescents in the child welfare system. Analyzing a random sample of 113 foster youth in a large Midwest state, the author found that foster youth experienced severe mental health problems such as depression, anxiety and loss of behavioral/emotional control. In this study, need for services, as measured by the presence of a mental health problem, was only partially related to mental health services received. Logistic regression analyses indicated that four factors including anxiety, child abuse history, poor psychological well-being, and time in care were significantly related to mental health service use.

The Relationship of Social Norms to Use of Services and Caregiver Burden in Japan

To develop an improved measure of "sekentei" (a social-psychological process that restricts behaviors that do not conform to social norms such as family caregiving) among family caregivers in Japan, and to describe the relationships among sekentei and caregiver's actual use of services, a reluctance to use services, and care burden. Descriptive correlational study. Family caregivers (N = 260) of impaired elders responded to a structured questionnaire. Exploratory and confirmatory factor analyses were used to assess the construct validity of the sekentei scale for caregivers (SSC). With the SSC, the relationships among main variables were verified. The SSC showed satisfactory reliability and validity. Sekentei was significantly correlated with care burden, but not to actual use or reluctance to use services. Sekentei is an important factor related to caregiver burden in Japan. Further research might include the extent to which sekentei is a factor in care burden in other cultures.

Inequalities in mental health care and social services utilisation by immigrant women

Background: The basic assumption of public health policy for immigrants Is that they ought to have equal access to hearth services compared to other population groups In Dutch society. However, little research is done on the actual use of mental health services by immigrants and literature seems to indicate inequalities in services utilisation by immigrant women. Methods: This study was conducted in Amsterdam, The Netherlands. Data on service utilisation were drawn from patient registers and came from care providers who were asked to keep up registration for some time to count the number of immigrant women referred to and in treatment. Results: Surinamese, Antillean, Turkish and Moroccan women made considerably less use of mental health care services than native-born women. On the other hand, immigrant women more frequently used social work facilities and women crisis intervention centres. Overall, they consulted the latter organizations nearly 1.5 times more frequently than mental health care services. The differences in service utilisation between the four immigrant groups are also discussed. Conclusions: This study explores the reasons for the ethnic defences in service utilisation. It argues that cultural and supply factors are largely responsible for the ethnic differences in use of mental hearth services. The differential use of social services is mainly ascribed to the socioeconomic status of the women concerned. The results imply that a care policy may improve the accessibility of mental health services for immigrant women. The most promising measure is by employing more ethnic and bilingual care providers.

Factors Associated With Formal Service Use by Family Members of Patients With Dementia

Thes study investigated actual service use by 152 dementia patients and used the Anderson model to examine factors associated with the use of in-home and out-of-home services. On the whole, practical issues tied to patient care were most powerfully related to the use of formal services in patients with relatively advanced dementia. Family caregiver appraisal, coping, and emo tional adjustment were not substantively tied to service use.