Family Health Status Research Articles

Determinants of Voluntary National Health Insurance Drop-Out in Eastern Sudan

Low enrolment and high drop-out rates are common problems in voluntary health insurance schemes. Yet, most studies in this research area focus on community-based health insurance and enrolment, rather than drop-out. This study examines what causes informal sector families not to renew their voluntary National Health Insurance Fund (NHIF) health insurance membership in Eastern Sudan. Primary data from about 600 informal sector households that dropped out or remained insured, collected through a household survey conducted in March 2014, were used. Logistic regressions were employed to examine what determines drop-out of the voluntary NHIF scheme. The logistic regression results are consistent with the existing literature and confirm the importance of household head, household and community characteristics. Notably, worse family health status and higher health care utilization decrease the probability of drop-out, which requires further analysis as it may indicate the problem of adverse selection and insufficient risk management. Most importantly, the results consistently show that household heads who are satisfied with health services and those who understand the main features of the voluntary NHIF scheme are less likely to drop out. Also, 30% of drop-out households hold a social support card and reported that the social support scheme is the main reason for not renewing their voluntary NHIF health insurance membership as they qualify for sponsored NHIF health insurance membership. This study shows that satisfaction with health services and knowledge of the health insurance scheme are important factors explaining drop-out of a national health insurance programme. The results suggest that education and information campaigns should be developed further to raise understanding of the NHIF voluntary scheme. In addition, information systems and coordination between the main agencies should be strengthened to reduce administrative costs and ensure policy coherence.

The sources of addiction and types of “socially acceptable” forms of addictive behavior in women with disorders of family health

Aim – determination of the sources of addiction and study of AB in women with disorders of family interaction for revelation of targets of the further psychocorrectional work with this contingent of married couples.Contingent - 321 married couple (MC), who asked for help because of disorder of family relations and “socially accepted” addictive behavior in women (studied group, SG). As the groups of comparison were also studied 50 MC with disorder of family health, in which women had not problems of addictive type (group of comparison 1, GC 1) and 50 conventionally harmonic MC (group of comparison 2, GC 2).Methods. Clinical-diagnostic and psychodiagnostic with use of АUDIT T. Baboor test, battery of АUDIT-like tests (composite authors under the supervision of I.V. Linsky) and the author methodology for revelation of disorders, connected with passion for sports (fitness) for amateurs of SPORT-UDIT.Results. There were separated three types of “socially accepted” addictive behavior, inherent to women with disorders of family relations that have akin pathogenetic mechanisms: behavior one (excessive passion for work, shopping, watching TV, internet, reading, computer games or games of chance; the main sources – shopping, work– 34,6 %; chemical one (intake of alcohol, tobacco, sedative-hypnotic preparations; the main source – tobacco)– 33,3 %; physiological one (excessive passion for food, sex, fitness, tea/coffee)– 32,1 %. These types of addictive behavior can be both isolated and combined with each other, creating in such a case the effect of mutual induction of adductive potential of person that has a negative influence on the family health status by the principle of vicious circle.Conclusions. The established clinical and pathogenetic features of addictive behavior formed the base at elaboration of the system of psychological correction and psychoprophylactic support of family health at dependent behavior in women

Georeferenced and secure mobile health system for large scale data collection in primary care

IntroductionMobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process. ObjectivesTo develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil. MethodsThe proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions; and two clients, (b) a Web Browser running visualization tools for management tasks, and (c) a data-gathering device (smartphone) to register and to georeference the family health data. A data security framework was designed to ensure the security of data, which was stored locally and transmitted over public networks. ResultsThe system was successfully deployed at six primary care units in the city of Sao Paulo, where a total of 28,324 families/96,061 inhabitants are regularly followed up by government health policies. The health conditions observed from the population covered were: diabetes in 3.40%, hypertension (age >40) in 23.87% and tuberculosis in 0.06%. This estimated prevalence has enabled FHTs to set clinical appointments proactively, with the aim of confirming or detecting cases of non-communicable diseases more efficiently, based on real-time information. ConclusionThe proposed system has the potential to improve the efficiency of primary care data collection and analysis. In terms of direct costs, it can be considered a low-cost solution, with an estimated additional monthly cost of U$ 0.040 per inhabitant of the region covered, or approximately U$ 0.106 per person, considering only those currently enrolled in the system.

Relationship between Marital Satisfaction and Mental Health of Married Women Referring to Health Centers in Sanandaj, Iran in 2014

BACKGROUND: As the most splendid social custom to attain security and emotional needs of adults, marriage has always won the approval of the community as a whole. In this regard, the endeavors of couples to preserve their relationships and achieve higher levels of marital satisfaction have been of great significance. As a component of personal characteristics, mental health has always been associated with marital satisfaction. This study investigated the relationship between marital satisfaction and mental health of married women referred to health centers in Sanandaj, Iran in 2014.METHODS: This was a cross-sectional study conducted on 393 women referring to the health centers in Sanandaj, Iran who were selected randomly in 2014. Data collection tool were ENRICH Marital Satisfaction Questionnaire and General Health Questionnaire (GHQ-28), which was completed by the participants in the study. Data were analyzed using SPSS version 16, descriptive, and analytical statistics.RESULTS: The results indicated that most of the patients were between 35-26 years, did not complete secondary school, were housewives, had only one child, and were married for 10 years. Most of the participants enjoyed marital satisfaction and had good mental health. There was a significant relationship between mental health and marital satisfaction (p<0.001). In terms of mental health, depression and marital satisfaction had the most significant negative correlation (p<0.001). However, there were no statistically significant relationship between female’s education and their employment with marital satisfaction and mental health.CONCLUSION: According to the findings of our study, in terms of the relationship between mental health and marital satisfaction, solving marital problems and increasing couples’ satisfaction can lead to the promotion of their mental health, leading to the increase in the health status of families and society a whole; hence, the significant role of family counseling centers.

The health status and well-being of low-resource, housing-unstable, single-parent families living in violent neighbourhoods in Philadelphia, Pennsylvania.

The health and well-being of single-parent families living in violent neighbourhoods in US cities who participate in housing programmes is not well described. This two-phase, mixed-methods study explores the health status of families who were participants in a housing-plus programme in Philadelphia, Pennsylvania between 2011 and 2013 and the relationship between the characteristics of the neighbourhoods in which they lived and their perceptions of well-being and safety. In phase 1, data collected with standardised health status instruments were analysed using descriptive statistics and independent sample t-tests to describe the health of single parents and one randomly selected child from each parent's household in comparison to population norms. In a subset of survey respondents, focus groups were conducted to generate an in-depth understanding of the daily lives and stressors of these families. Focus group data were analysed using content analysis to identify key descriptive themes. In phase 2, daily activity path mapping, surveys and interviews of parent-child dyads were collected to assess how these families perceive their health, neighbourhood and the influence of neighbourhood characteristics on the families' day-to-day experience. Narratives and activity maps were combined with crime data from the Philadelphia Police Department to analyse the relationship between crime and perceptions of fear and safety. Phase 1 data demonstrated that parent participants met or exceeded the national average for self-reported physical health but fell below the national average across all mental health domains. Over 40% reported moderate to severe symptoms of depression. Parents described high levels of stress resulting from competing priorities, financial instability, and concern for their children's well-being and safety. Analysis of phase 2 data demonstrated that neighbourhood characteristics exert influence over parents' perceptions of their environment and how they permit their children to move within it. This research suggests the need for robust research, programmatic and policy interventions to support housing-unstable families who live in neighbourhoods with high levels of violence.

Show Me My Health Plans: a study protocol of a randomized trial testing a decision support tool for the federal health insurance marketplace in Missouri.

BackgroundThe implementation of the ACA has improved access to quality health insurance, a necessary first step to improving health outcomes. However, access must be supplemented by education to help individuals make informed choices for plans that meet their individual financial and health needs.Methods/DesignDrawing on a model of information processing and on prior research, we developed a health insurance decision support tool called Show Me My Health Plans. Developed with extensive stakeholder input, the current tool (1) simplifies information through plain language and graphics in an educational component; (2) assesses and reviews knowledge interactively to ensure comprehension of key material; (3) incorporates individual and/or family health status to personalize out-of-pocket cost estimates; (4) assesses preferences for plan features; and (5) helps individuals weigh information appropriate to their interests and needs through a summary page with “good fit” plans generated from a tailored algorithm. The current study will evaluate whether the online decision support tool improves health insurance decisions compared to a usual care condition (the healthcare.gov marketplace website). The trial will include 362 individuals (181 in each group) from rural, suburban, and urban settings within a 90 mile radius around St. Louis. Eligibility criteria includes English-speaking individuals 18–64 years old who are eligible for the ACA marketplace plans. They will be computer randomized to view the intervention or usual care condition.DiscussionPresenting individuals with options that they can understand tailored to their needs and preferences could help improve decision quality. By helping individuals narrow down the complexity of health insurance plan options, decision support tools such as this one could prepare individuals to better navigate enrollment in a plan that meets their individual needs. The randomized trial was registered in clinicaltrials.gov (NCT02522624) on August 6, 2015.

Exploring the risk factors contributing to suicide attempt among adolescents: A qualitative study.

Background:Since suicide attempt among adolescents is a major challenge and the reasons why this age group attempt suicide are complex, the aim of this study was to investigate the risk factors that contribute to suicide attempt among adolescents.Materials and Methods:In this qualitative content analysis, 14 adolescents (12–19 years old) who were admitted in two hospitals in Shiraz, Iran, were interviewed. Participants who tried attempt suicide with medication were selected by purposive sampling and the data were gathered by semi-structured interviews. Data analysis was guided by the conventional approach of qualitative content analysis.Results:Three major themes and 13 subthemes emerged from data analysis. The main themes were: (a) Individual factors and experiences (psycho-emotional problems, puberty, religious beliefs, stress management strategies, marriage and love, field and level of education); (b) family factors (family structure, family relationship, family economic features, family health conditions); and (c) social factors (suicidal behavior in others, media influence, professional support).Conclusions:This study identified three major themes related to suicide attempt among adolescents in the context. As a result, suicide prevention and care provision should formulate a comprehensive method, considering the interaction of medical besides individual, familiar, and social factors in their assessment and care provision.

Predictors of Family Function in DMD and SMA Family

Introduction: The progressive disability creates a low quality of life for families of children with muscular dystrophy. The families experience family overload, resulting in the alienation of family members and the common occurrence of caregiver burden, and resulting economic burden. Purpose: The purposes of the study were to identify the differences in family characteristics, health needs, lifestyle, and overall family health status between cohorts of families with a child from either Duchenne muscular dystrophy (DMD) or spinal muscular dystrophy (SMA). And analyzed the predictive factors influence the major health-associated variables. Methods: Analyzes were conducted on data derived from 86 of families with DMD or SMA. Participants (113, mean age: 42.68 years) included the patient’s parents, siblings, and other caregivers of children with DMD and SMA. The data were obtained using selfreported questionnaires. Results: The results show that family support, family hardiness, the power to propose an idea/plan, and family incomes are predictors for family functioning. Gender, education, income, time spent watching TV, and the power to propose an idea or plan constituted important characteristics influencing this model of family health and family function. Conclusion: The results of this knowledge are important for development of professional strategies and treatment plans.

"What about FH of my child?" parents' opinion on family history collection in preventive primary pediatric care.

Family history (FH) in Preventive Primary Pediatric Care is to identify children at risk for complex diseases and provide personal preventive strategies. This study was to assess parents' opinion on FH collection. Semi-structured interviews were conducted. Among issues addressed were: former experiences with FH, knowledge about FH, family definition and sharing information about FH. The importance of FH for participants depended on their knowledge, perceived family health status and former experiences. After insight into FH, parents shift to believing it to be important, but certain barriers exist in reporting FH. Parents suggest that the importance of FH should be more emphasized and more trusting relationship with Preventive Primary Pediatric Care should be invested in.

The experience of programs to promote health in retirement: a systematic review of qualitative evidence.

Retirement is a transition that occurs at the conclusion of the work phase of life, after years in which work has played an important role, and this can interfere with every dimension of the human ageing process. It can be seen as an event, as a status or as a process. Independently of these perspectives, intervention programs can promote the health status of individuals and their families during this life transition. Aging is one of the major issues affecting the current public health framework. For many societies there will be an increasing population of older persons leading to an increase the number of people living with chronic diseases and associated morbidity. As such, there is an urgent need to implement strategies that promote health and the quality of life in stage. The objective of this review was to identify programs that have been implemented with the goal of promoting the health of individuals and their families during their adjustment to retirement and identify the meaningfulness and appropriateness of programs implemented to improve the health status of individuals and families during their adjustment to retirement. This review considered studies that included individuals newly retired (within five years of retirement) and their families. We did not consider any age range; what was important was the experience of the individual, independent of the age in which this transition occurred. This review considered studies that investigated the experiences of individuals and families during the initial retirement period who were subject to programs implemented to improve their health status, excluding programs that had returning to the labor market as a goal. Types of studies: This review considered interpretive or critical studies that drew on the experiences of individuals and their families including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. In the absence of research studies, other text such as opinion papers and reports were considered. The search strategy aimed to find both published and unpublished studies. An initial search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. Using all identified keywords and index terms, another search was then undertaken across all included databases. The reference list of all identified reports and articles was searched for additional studies. Studies published in Portuguese, English and Spanish, and those published from 2000 to 2013 were considered for inclusion. The number of potentially relevant studies identified following the search was 567. Of these, seven were excluded as duplicates; of the remaining 560, from the title and abstract assessment, 540 were excluded, and 20 out of the 20 articles were excluded for not fulfilling the inclusion criteria when the full text was read. There were no studies located that met the inclusion criteria of this review. There is currently no evidence available to determine the meaningfulness and appropriateness of programs that have been implemented to improve the health status of individuals and families during their adjustment to retirement. According to the conducted analysis, health promotion in retirement is an area which needs scientific and economic investment as there is a lack of evidence that describes programs directed to retirees and their families and that measure the meaningfulness and appropriateness in what concerns their health status.

Health Insurance, Job Lock, and the Supply of Self‐Employment

Unlike most wage earners, self‐employed Americans have limited access to health insurance and face higher costs. Thus, social commentators and policymakers argue that many potential entrepreneurs are “locked” into their current jobs for fear of losing their health coverage even though they could be more productive in self‐employment. Using a large data set for the period 2000–2008, we find the availability of employer‐provided health insurance to be negatively correlated to the likelihood of self‐employment in the long run, but the effect to be mediated by individual and family health status. However, we find employer‐provided health insurance to have no significant effect on the probability of switching in the short run. Finally, we find differences in the magnitude of the effects between our samples of husbands and wives.

Assessment of Nursing Aptitude on Entry to Nursing Programme: Can it be Assessed?

Nursing is an art, a skill and a profession in demand to help nations realize their health care goals. Effective nurses transform the health status of individuals and families. However the incoming reports of poor quality nursing care and growing attention of Health Care Managements to select competent nurses have called nursing professionals to give a thought on 'quality of potential nurses'. This paper reports the development of a Nursing Aptitude Test (NAT) for selecting candidates for B. Sc. Nursing programme. It was developed based on the various skills considered necessary for nursing profession. The tool revealed positive relationship of nursing aptitude with academic and clinical performance, moreover was sensitive to training. The tool might be used to predict academic and clinical performance of BSc Nursing students in India. There is scope for exploration on usefulness of the tool to predict competent nurse workforce and effective nursing care.

Risk factors for burden development of caregivers of people with mental disorders

Mental disorders have consequences on patient's family. Caregiver burden represents the extent to which caregivers perceived their emotional, physical health, social life and financial status as a result of caring for their relative. There is a large number of factors which contribute to the development of caregiver burden. Factors related to patients are objective burden of care, and they are: the type of the disorder, symptoms, patient's needs, current prognosis of the disorder and their behavior, which is an objective burden of care. Factors related to caregivers, which are subjective burden of caregiving, are: their personality, emotional status and subjective perception of nursing. The mediator variables are: family relationships, social support, coping strategies, socio-economic status, gender, health status, culture and other life events. This phenomenon can be avoided and it is necessary to work on the prevention of caregiver burden.

Understanding perception and factors influencing private voluntary health insurance policy subscription in the Lucknow region.

Health insurance has been acknowledged by researchers as a valuable tool in health financing. In spite of its significance, a subscription paralysis has been observed in India for this product. People who can afford health insurance are also found to be either ignorant or aversive towards it. This study is designed to investigate into the socio-economic factors, individuals' health insurance product perception and individuals' personality traits for unbundling the paradox which inhibits people from subscribing to health insurance plans. This survey was conducted in the region of Lucknow. An online questionnaire was sent to sampled respondents. Response evinced by 263 respondents was formed as a part of study for the further data analysis. For assessing the relationships between variables T-test and F-test were applied as a part of quantitative measuring tool. Finally, logistic regression technique was used to estimate the factors that influence respondents' decision to purchase health insurance. Age, dependent family members, medical expenditure, health status and individual's product perception were found to be significantly associated with health insurance subscription in the region. Personality traits have also showed a positive relationship with respondent's insurance status. We found in our study that socio-economic factors, individuals' product perception and personality traits induces health insurance policy subscription in the region.

Association of depression & health related quality of life with body composition in children and youth with obesity

BackgroundThere is an increasing recognition of the relationship between mental illness and obesity in the pediatric population. Our objective was to explore the individual, biological and family determinants of depressive symptoms and HRQOL in youth with obesity in a clinical setting. MethodsWe studied 244 youth aged 8–17 years at the time of entry to a weight management program. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale for Children questionnaire, with a score of ≥15 or antidepressant use indicating depression. HRQOL was examined using the PedsQL4.0. We considered the influence of age, sex, health history, anthropometry, body fat, family health and socioeconomic status (SES) on depression and HRQOL. ResultsDepression was common in this population (36.4%). In multivariate analysis, the extent of obesity (body fat) predicted both depression (OR 1.1 (1.0–1.2); p=0.05) and low HRQOL scores (β −0.63 (p<0.001)). Family SES was an important predictor of depression but not of HRQOL. In contrast to population-based studies, sex, age, pubertal status and family history of depression did not predict depressive symptoms. LimitationsAs this study included children and adolescents seeking obesity treatment, results may not be generalizable to the general population of obese youth. ConclusionsDepression and low HRQOL are common in youth entering weight management programs. Extent of obesity predicted depressive symptoms and low HRQOL. Predictors of depression in this population differ from non-obese populations studied. It is important to consider these characteristics to assist clinicians in identifying these children.

The experience of programs to promote health in newly retired adults and their families: a qualitative systematic review protocol

Review question/objective The objective of this review is to identify the meaningfulness and appropriateness of programs that have been implemented to improve the health status of individuals and families during the retirement period. More specifically, the review will focus on the following questions: Which programs have been implemented with the goal of promoting the health of individuals and their families during retirement period? What are the experiences of individuals and their families during retirement of programs that have been implemented with the goal of promoting their health? Inclusion criteria Types of participants This review will consider studies that include individuals newly retired (within five years of retirement) and families of newly retired individuals (within five years of retirement). We will not consider any age range, what is important is the experience the individual feels independently of the age in which this transition is lived. Any kind of retirement is acceptable, independently of the reasons and contexts of retirement. Phenomena of interest This review will consider studies that investigate the experiences of individuals and families during the retirement period that were subject to programs implemented to improve their health status, excluding programs that have as goal the return to the labor market. In this systematic review, we intend to find any kind of program, independently of the context or if it is conducted in group or one to one.

4대 중증질환자와 혈연 관계자에 대한 명리학적 선천성질환 특성요인 분석 -서울시 요양원 입소노인을 중심으로-

본 연구는 4대 중증질환자와 혈연 관계자에 대한 명리학적 선천성질환 특성요인을 파악하고자 한다. 연구기간은 2013년 3월15일부터 7월31일까지이며, 연구대상자는 서울시에 소재하는 요양시설에 입소한 노인들 중에서 4대중증질환자와 혈연 관계자에 대한 각각 147명을 대상으로 실시하였다. 자료 분석은 SPSS/WIN 18.0 프로그램을 이용하여 빈도분석, 카이스케어 검정을 통계적으로 분석하였다. 연구결과는 4대 중증질환자와 혈연 관계자의 질환특성요인이 매우 유사하게 나타났으며, 선천성질환 중에서 뇌혈관질환이 가장 유의미하게 나타났다. 그리고 혈연 관계자의 건강관련 특성요인에 따른 4대 중증질환자는 유의미한 차이가 있었다. 본 연구의 결과에 의한 시사점은 4대 중증질환자와 혈연 관계자에 대한 명리학적 선천성질환이 유의미하게 나타났으므로 혈연 관계자의 질병예측기초자료가 될 것으로 사료된다. The objective of this study is to identify key attributes to congenital disease factors regarding the patients of the four most-common serious chronic illnesses and their relatives in the light of Myeongrihak. For the purpose of this study, a survey was conducted from March 15 to July 31, 2013, of 147 elderly people with the four most-common serious chronic illnesses admitted to nursing homes located in Seoul. Data were analyzed by frequency analysis and Kai-square tests by use of SPSS/WIN 18.0. The analysis found that the patients and their relatives had very similar disease factors, and cerebrovascular diseases presented the strongest correlations. The subjects also showed meaningful differences according to the health factors of their relatives. As this study found that meaningful correlations regarding congenital diseases between patients of the four most-common serious chronic illnesses and their relatives in the light of Myeongrihak, this will serve as basic data to predicts health conditions of families and relatives.

Bayesian estimation of log odds ratios over two-way contingency tables with intraclass correlated cells

In this article, a Bayesian approach is proposed for the estimation of log odds ratios and intraclass correlations over a two-way contingency table, including intraclass correlated cells. Required likelihood functions of log odds ratios are obtained, and determination of prior structures is discussed. Hypothesis testing for log odds ratios and intraclass correlations by using the posterior simulations is outlined. Because the proposed approach includes no asymptotic theory, it is useful for the estimation and hypothesis testing of log odds ratios in the presence of certain intraclass correlation patterns. A family health status and limitations data set is analyzed by using the proposed approach in order to figure out the impact of intraclass correlations on the estimates and hypothesis tests of log odds ratios. Although intraclass correlations are small in the data set, we obtain that even small intraclass correlations can significantly affect the estimates and test results, and our approach is useful for the estimation and testing of log odds ratios in the presence of intraclass correlations.

Food Choices and Health Status of Food Insecure Families

Food Choices and Health Status of Food Insecure Families

대전지역 주부의 건강식생활과 관련된 식습관과 식품구매행동 조사

This survey was conducted to compare the housewife's food habit and food purchase behavior on healthy dietary life. The questionnaires were collected from 151 working housewives and 159 housewives in Daejeon. The average meal time was 20~30 min., 67.6% of respondents ate breakfast and bap with guk(72.9%) was the most favourite foods. Almost half of them ate egg, fruit, vegetable everyday. They concerned highly about less intake of frozen foods(64.2%) and food additives(61.6%) for wellbeing dietary life. Because of close distance and various foods items, big discount store was chosen as food purchase place. The most considering purchase factor was food additives in working housewife and nutrition in housewife(p<0.05). In grocery shopping, working housewife considered children and their husbands(p<0.05). The most important purchase factor was the freshness in vegetables fishes fruits seaweeds eggs. TV or Radio was utilized the most frequently to obtain the useful knowledge on healthy foods. It is suggested that practical information should be offered housewives to purchase proper foods within their income and to manage dietary life according to their family's health condition.