Differences In Healthcare Seeking Behaviors Research Articles

Associations between health care seeking and socioeconomic and demographic determinants among people reporting alarm symptoms of cancer: a population-based cross-sectional study

Late diagnosis of cancer may partly be explained by the fact that some patients do not seek health care promptly when experiencing an alarm symptom. Socioeconomic and demographic differences exist concerning knowledge and awareness of cancer alarm symptoms in the general population and socioeconomic differences are found in cancer incidence and survival. We therefore hypothesise that socioeconomic and demographic differences in health care-seeking behaviour are present among people with alarm symptoms. To analyse associations between health care seeking and socioeconomic and demographic factors among people reporting cancer alarm symptoms. A questionnaire survey comprising 20000 people aged >20 from the Danish population. The questionnaire concerned alarm symptoms of common cancers and subsequent health care seeking. Data on socioeconomic factors were obtained from Statistics Denmark. health care seeking and patient interval. A total of 26.1% of all subjects reported that they did not seek health care when having experienced an alarm symptom. Women-subjects aged >40, subjects living with a partner and subjects having a cancer diagnosis-were more likely to seek health care, whereas medium educational level was negatively associated with health care seeking. Further, women were more likely to seek health care within 1 month, whereas subjects out of the workforce were less likely to do so. Approximately three out of four subjects sought health care when having experienced an alarm symptom but 50% waited for at least 1 month. Some demographic factors were found to be associated with health care-seeking behaviour and the patient interval, whereas no consistent associations were found with regard to socioeconomics.

The case test-negative design for studies of the effectiveness of influenza vaccine

BackgroundA modification to the case–control study design has become popular to assess vaccine effectiveness (VE) against viral infections. Subjects with symptomatic illness seeking medical care are tested by a highly specific polymerase chain reaction (PCR) assay for the detection of the infection of interest. Cases are subjects testing positive for the virus; those testing negative represent the comparison group. Influenza and rotavirus VE studies using this design are often termed “test-negative case-control” studies, but this design has not been formally described or evaluated. We explicitly state several assumptions of the design and examine the conditions under which VE estimates derived with it are valid and unbiased. MethodsWe derived mathematical expressions for VE estimators obtained using this design and examined their statistical properties. We used simulation methods to test the validity of the estimators and illustrate their performance using an influenza VE study as an example. ResultsBecause the marginal ratio of cases to non-cases is unknown during enrollment, this design is not a traditional case-control study; we suggest the name “case test-negative” design. Under sets of increasingly general assumptions, we found that the case test-negative design can provide unbiased VE estimates. However, differences in health care-seeking behavior among cases and non-cases by vaccine status, strong viral interference, or modification of the probability of symptomatic illness by vaccine status can bias VE estimates. ConclusionsVaccine effectiveness estimates derived from case test-negative studies are valid and unbiased under a wide range of assumptions. However, if vaccinated cases are less severely ill and seek care less frequently than unvaccinated cases, then an appropriate adjustment for illness severity is required to avoid bias in effectiveness estimates. Viral interference will lead to a non-trivial bias in the vaccine effectiveness estimate from case test-negative studies only when incidence of influenza is extremely high and duration of transient non-specific immunity is long.

Health seeking behavior of the mother for the special care new-born units discharged child: A comparative study

Establishment of special care new-born units (SCNU) in hospitals not only serves to provide the intensive care to sick neonates, but presents with opportunities to enhance knowledge and modify attitude and practices of their parents through behavior change communication (BCC). A cross-sectional study was conducted in Dibrugarh District, Assam from January to June, 2011 to assess differences in health-care seeking behavior of these mothers from mothers of newborns who were born at home and mothers who had normal uneventful institutional deliveries. Mothers of 29 SCNU discharged, 34 institutions delivered and 26 home delivered children were interviewed using a semi-structured interview schedule and a knowledge, attitude and practice (KAP) survey tool. Mothers of children admitted to SCNU scored better in questions related to vaccination, contraception, protection of child from infections and cold and perceptions about traditional healers, but overall KAP scores in the three groups were not found significantly different.

Sex differences in health care-seeking behavior for acute coronary syndrome in a low income country, Peru.

: Recognizing reasons for prehospital delay after symptoms of acute coronary syndrome (ACS) is established in developed countries yet evidence from Latin America is limited. We aimed to assess ACS symptom recognition, health care-seeking behavior, and confidence in local health care facilities to take care of ACS by gender in a sample of Peruvians. : A community-based interview survey in a peri-urban area in Lima, Peru. The 24-item study instrument included vignettes and questions assessing identification of urgent and emergent ACS symptoms, anticipated help-seeking behaviors, and confidence in local health care facilities. : In the study population (90 people; 45.6% men; mean age, 43.5 years), women were 4 times less likely to correctly attribute symptoms of chest pain to the heart (OR = 0.23; 95% CI: 0.063-0.87; P = 0.03). Women were much more likely to respond that a man would "Seek help" (OR = 4.54; 95% CI: 1.21-16.90; P = 0.024) and that "Yes," a woman would be less likely to seek help for chest pain symptoms (OR = 3.26; 95% CI: 1.13-9.41 P = 0.029) after adjusting for age, education level, age at migration, and history of chest pain. Women were less likely than men to think that their local Health Care Post would help them if they had a heart attack (2.1% vs. 14.6%; P = 0.04), and only 18.7% of women believed that their local emergency room would help them. : Our findings suggest women are less likely to seek help for chest pain and women and men in a peri-urban area in Peru are not confident in their local health care facility to treat urgent or emergent ACS symptoms.

Higher rate of culture-confirmed Campylobacter infections in Australia than in the USA: is this due to differences in healthcare-seeking behaviour or stool culture frequency?

Laboratory-based surveillance by OzFoodNet in Australia and FoodNet in the USA indicated that the incidence of Campylobacter infections in 2001 in Australia was about nine times higher than in the USA. We assessed whether this disparity could be explained by differences in the frequency of stool culturing. Using data from population surveys of diarrhoea and symptom profiles for Campylobacter from case-control studies, indices of healthcare behaviour taking into account the severity of Campylobacter infections were calculated. These suggest that culture-confirmed Campylobacter infections underestimate the incidence of community cases by similar ratios in the two countries. The incidence of Campylobacter infections in Australia was about 12 times higher than in the USA after consideration of healthcare system differences.

Gender Differences in Healthcare-Seeking Behavior for Urinary Incontinence and the Impact of Socioeconomic Status

Despite the gender difference in etiology, prevalence and management of urinary incontinence (UI) among community-living older adults, little is known about the effect of gender on their healthcare-seeking behaviors. To determine gender differences in professional care seeking, receipt of UI treatment, and the impact of age and socioeconomic status. National survey of Medicare managed care enrollees in 2003 and 2004. A total of 28,724 patients who were noninstitutionalized, age 65 and older, and had self-reported UI problem in the last 6 months. Whether a patient with UI had discussed the problem with a health provider, and whether a patient having had such a discussion received treatment. Compared with incontinent men, incontinent women were less likely to seek professional help for the UI problem [46.2% vs. 55.7%; adjusted odds-ratio (AOR) = 0.65, P < 0.01], but more likely to receive treatment (54.8% vs. 51.4%; AOR = 1.12, P < 0.01) after consulting a health professional. These gender differences varied by age, education, or annual household income level. For incontinent women, the predicted rate of receiving treatment decreased with older age, lower education, and lower income level. Community-living older women with UI problem are less likely to seek professional help than their male counterparts, but more likely to be treated after a health professional is consulted. Patients' socioeconomic status can affect physician behavior and ultimately, their receipt of treatment of UI, especially for women. Current efforts to promote awareness and quality-of-care of UI among older adults should account for gender and other sociodemographic factors.

Ethnic differences in healthcare-seeking behaviour and management for acute chest pain: secondary analysis of the MINAP dataset 2002–2003

Objective:To examine whether there are ethnic differences in the healthcare-seeking behaviour and management of patients with chest pain.Design:Prospective cohort of patients attending accident and emergency departments with chest pain.Setting:Hospitals in...

Gender differences in health care-seeking behavior for sexually transmitted diseases: a population-based study in Nairobi, Kenya.

Health care-seeking behavior for sexually transmitted diseases (STDs) is important in STD/HIV control. The goal of this study was to describe the proportion seeking care, patient delay, and choice of provider among men and women with STD-related complaints in Nairobi, Kenya. A population-based questionnaire was administered in 7 randomly selected clusters (small geographic areas covering approximately 150 households each). Of the 291 respondents reporting complaints, 20% of men versus 35% of women did not seek care, mainly because symptoms were not considered severe, symptoms had disappeared, or as a result of lack of money. Of those who sought care, women waited longer than men (41 vs. 16 days). Most men and women went to the private sector (72% and 57%, respectively), whereas the informal sector was rarely visited (13% and 16%, respectively). Relatively more women visited the government sector (28% vs. 15%). Because women were mostly monogamous, they did not relate their complaints to sexual intercourse, which hampered prompt care-seeking. Women should be convinced to seek care promptly, eg, through health education in communities.

Impact of sex and gender on irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and change in defecation pattern. This review addresses the topic of possible sex (genetic, biological) and gender (experiential, perceptual) differences in individuals with and without IBS. Several observations make the topic important. First, there is a predominance of women as compared to men who seek health care services for IBS in the United States and other industrialized societies. Second, menstrual cycle-linked differences are observed in IBS symptom reports. Third, women with IBS tend to report greater problems with constipation and nongastrointestinal complaints associated with IBS. Fourth, serotonin (5-HT3) receptor antagonist and 5-HT4 partial agonist drugs appear to more effectively diminish reports of bowel pattern disruption in women with IBS as compared to men. This review examines sex and gender modulation of gastrointestinal motility and transit, visceral pain sensitivity, autonomic nervous system function, serotonin biochemistry, and differences in health care-seeking behavior for IBS.

Health-seeking behaviour of individuals with a cough of more than 3 weeks

Sex inequalities can lead to poorer access to health care and delays to diagnosis of tuberculosis in women. In a population-based survey we assessed health-seeking behaviour in adults with long-term cough. The prevalence of cough was 1% (213) and 2% (279) in men and women, respectively. Women took more health-care actions than men, but chose less qualified providers and reported lower health expenditure per visit. Delay before seeking hospital treatment was longer for women (41 days) than men (19 days; p=0.04), and more men (27; 36%) than women (14; 14%; p=0.0006) reported giving a sputum sample at hospital. Sex-sensitive strategies for tuberculosis control are needed and should take into account sex differences in health-care seeking behaviour as well as a possible sex bias among health-care providers.