Health Care Posts Research Articles

Prevalence of scabies and its associated environmental risk factors among the Forcibly Displaced Myanmar Nationals living in the Cox's Bazar district of Bangladesh

IntroductionThe Forcibly Displaced Myanmar Nationals (FDMNs) residing in refugee camps face various health challenges, including a rising prevalence of scabies, exacerbated by overcrowded conditions and limited healthcare access. This study aims to assess scabies prevalence, clinical features, and environmental factors among FDMNs, aiding interventions and recommendations for better health outcomes. MethodologyA cross-sectional study was conducted from April to May 2023 in six camps of Teknaf/Ukhia Cox's Bazar. Using a multistage sampling technique, 12 blocks were identified, and FDMNs seeking healthcare services from Primary Health Care posts were invited to participate in the study. Participants were adults, and children who volunteered to participate in this study. Scabies diagnosis was based on clinical examinations of exposed body areas by trained health professionals. Data on sociodemographic factors, environmental risk factors, and scabies symptoms were obtained through a semi-structured questionnaire administered by trained interviewers. Statistical analysis included descriptive statistics, Chi-square tests, and binary logistic regression models to explore associations between scabies infection and other explanatory factors. ResultA total of 679 FDMNs participated in the study, with a mean age of 29.13 years. Overall, 66.42 % of participants were diagnosed with scabies. Age, marital status, history of scabies infection, previous skin infection, family history of scabies and skin infection, floor type, pet animal, dust exposure, and seasonal exposure were significantly associated with the scabies infection. Binary logistic regression suggested that having history of scabies infection (OR 3.98, 95 % CI: 1.86 to 8.49, p < 0.001), skin infection (OR 2.46, 95 % CI: 1.32 to 4.58, p = 0.004), having family history of scabies infection (OR 3.06, 95 % CI: 1.29 to 7.23, p = 0.011), family history of skin infection (OR 27.41, 95% CI: 14.46 to 51.97, P < 0.001), having contact with street animal (OR 2.16, 95% CI: 1.27 to 3.66, P = 0.004), and winter season (OR 3.33, 95 % CI: 1.89 to 5.87, p < 0.001) were significantly associated with scabies infection. ConclusionTailored public health measures targeting hygiene, living conditions, and animal contact can mitigate the spread of scabies, particularly among vulnerable groups like Rohingya refugees, necessitating collaboration between stakeholders.

Responses to Mental Health Care Posts by Social Media Influencers: The Moderating Effects of Previous Experience and Follower Involvement

ABSTRACT Mental health information on social media is more often communicated by regular users as opposed to healthcare professionals, and a subset of these regular users, social media influencers, are employed as marketing sources for therapy companies. According to social cognitive theory, an influencer’s story about their positive experiences with therapy should encourage followers to also seek therapy, and stronger involvement with the influencer should enhance these effects. Although research has found that previous experience with modeled behaviors may mute vicarious learning effects, with a nuanced and stigmatized context like mental health treatment, it is important to parse out both the quantity and valence of previous experience in understanding how it shapes audience responses to mental health content on social media. The current study tests a moderated mediation model to help explain the impact of previous viewer experience with therapy (quantity and valence) and involvement with the influencer (similarity and parasocial relationship) on social cognitive theory-related outcomes. Results indicate no interaction effects of the moderators; however, there were direct positive effects of previous viewer experience and SMI outcome on outcome expectations, which in turn positively predicted behavioral intentions to seek therapy. Interestingly, self-efficacy had a negative effect on behavioral intentions.

The Health Promotion Effect of Public Health Care Post User: Focusing on Hypertension and Diabetes Control Rate

Background/Objectives: The purpose of this study is to develop health promotion performance indicators and analyze the health promotion effects of public health care posts. Methods/Statistical analysis: A number of previous studies and existing health care assessment indicators were used to develop health promotion indexes for public health care posts. The health promotion effects were classified and analyzed according to the developed evaluation indicators. The effect of pre-and post-health promotion program were analyzed using blood pressure and blood glucose level. Findings: The health promotion performance indicators of public health care posts are classified into structure, process, and result. In particular, the indicators of health promotion results are suggested as health life practice, chronic disease management, infectious disease management and population health management. The health promotion effect was analyzed according to these indicators; smoking, drinking, exercise, obesity, oral health, hypertension, diabetes, cholesterol, depression, cancer, vaccination, dementia management, and elderly activity limit reduction. Blood pressure and blood sugar data were analyzed to measure the before and after effect of using the public health care posts. The blood pressure and glucose control rate for public health care post users are higher than the results of Korea National Health and Nutrition Examination Survey. The severity of hypertension was also lower than the severity data reported in the National Health Insurance. The high control rate of hypertension and diabetes suggest that public health care posts perform health promotion programs efficiently for residents in medical vulnerable areas. Improvements/Applications: In order to measure more valid and reliable effects, it is necessary to manage and measure the health promotion evaluation indicators presented in this study.

How Much Do Older Adults Living Alone in Rural South Korea Know About Dementia?

ObjectivesThis study aimed to examine the level of dementia knowledge of older Korean adults living alone in rural areas and to identify related factors.MethodsA cross-sectional descriptive design was applied. The participants were 231 older adults living alone who were recruited from 12 of the 13 primary health care posts in the rural area of Chuncheon. Participants’ level of dementia knowledge was assessed using the Dementia Knowledge Scale. Data were analyzed using descriptive statistics, and the t-test, analysis of variance, chi-square test, and Mann-Whitney test were applied.ResultsParticipants’ mean age was 77.3±5.4 years, and women comprised 79.7% of the sample. Over half of the participants (61.9%) had no formal education, and all the participants were enrolled in Medical Aid. The participants’ average percentage of correct answers was 61.6%. The highest rate (94.4%) was for the item “Dementia can change one’s personal character.” The item with the lowest proportion of correct answers was “Dementia is not treatable” (23.4%). Dementia knowledge was significantly associated with age, education, health coverage, source of living expenses, and dementia risk.ConclusionsDementia knowledge among Korean rural older adults living alone was relatively low. Participants’ misconceptions about symptoms and treatment could hinder them from seeking early treatment. The results of this study suggest the need for active outreach and health care delivery for rural older adults living alone in South Korea.

The Analysis of Health Promotion Benefits on Public Health Care Posts

Public Health Care Posts (PHCHs) are the primary medical institutions for the health promotion of residents in medical vulnerable areas. This study proved the effectiveness of health promotion services provided by PHCHs. This study uses benefit analysis to evaluate the economic value of health promotion on PHCPs. The benefits were analyzed by health promotion services and by region. The benefits of reducing outpatient and inpatient medical expenses, saving time, preventing complications, and life extension was included. The health benefits for hypertension were estimated at $43, 921, and the benefits for diabetics were estimated at $38, 909. The benefits from the vaccination of the PHCPs were $69, 759. Benefits from dementia management services were $443, metal health care service $997, oral health care $1, 634, and benefits from medication adherence management were $1, 439. Total benefits of health promotion services at PHCPs were estimated at $157, 102 per year. By region, the benefits of rural areas were the greatest. Since the health promotion benefits of PHCPs are estimated to be considerably high, it will be possible to increase the efficiency of PHCPs by expanding health promotion service programs.

Strategies for reestablishing the role of Public Health Care Posts in Korea

This study aims to identify the current public health care posts status, analyze the surrounding environment, and suggest the future role of public health care posts. To redefine the function of the public health care posts, the public health care posts were classified into four types. The classification was based on the existence of a medical facility in the region, the arrival time to medical institutions in case of emergency, and the frequency of emergencies. As the result of this study, 3.1% of the total public health care posts were required to strengthen the function of the clinic medical care and 9.5% of the public health care posts should maintain the current medical care function. 54.9% of the public health care posts should strengthen the health promotion function and 32.5% of the public health care posts should be transferred to health promotion role. Most public health care posts need to expand their role from medical care to health promotion, so institutional support should be provided.

Turning point: Empathetic outreach.

Transgender neuroscientist tackles under-represented minorities’ access to health care and academic posts. Transgender neuroscientist tackles under-represented minorities’ access to health care and academic posts.

Validation of Health Extension Workers Job Motivation Scale in Gamo-Gofa Zone, Southern Ethiopia: A Cross-Sectional Study.

Introduction. Well-trained and highly motivated community health workers are critical for delivery of community-based health care services. Understanding what motivates especially community health care providers for better community health requires the use of psychometrically reliable and valid scale. This study was conducted to validate job motivation scale in Gamo Gofa Zone, Southern Ethiopia. Methods. A cross-sectional study was conducted in 150 health care posts in Gamo Gofa Zone, from February 01, 2013, to March 01, 2013. A total of 301 participants responded to questionnaires asking about sociodemographic characteristics and job motivation. Exploratory factor analysis with principal component extraction and varimax with Kaiser Normalization rotation were employed to develop scales for job motivation. Eigenvalues greater than 1 were used as criterion of extraction. Items with item factor loadings less than 0.4 and double loaded items were dropped. Alpha and exploratory factor analyses were examined to test reliability and validity of the scale. Results. During exploratory factor analysis eight factors emerged from the three dimensions of job motivation scale, namely, educational career, workload, financial incentive, supervisor encouragement, community recognition, access to infrastructure, living condition, and better achievement in work. The factor loadings of the items in each dimension ranged from 0.58 to 0.83. Crobach's alpha of the scales ranged from 0.79 to 0.90. To check validities of the scales developed in this study, the previous studies conducted to develop job motivation scale were used. Conclusion. Although the present scale has the potential to measure the job motivation of health extension workers and it is low in cost and easy to administer and analyze, it should be field-tested at different settings.

The Effect of Korean Dance Program on Climacteric Symptoms and Blood Lipid in Rural Middle-aged Women

This study is to verify the effects of the Korean Dance Program for rural middle-aged women on their total cholesterol, triglyceride and climacteric symptoms. In this study, 'Harmony‘, one of the sub-programs of the Korean Dance Program which was developed at Seoul National University Institute Ageing of Woorichum Gymnastics was applied. It was composed of 13 actions and music. Nonequivalent control group pre/post-test method was adopted. Participants of this study lived in rural community, and recruited from two Primary Health Care Posts located in rural community of D city. Total 41 women (experimental group 20, control group 21), from 40s to 60s, were finally selected. Data collection was carried out for 16 weeks. The results were summarized as follows: the total blood cholesterol(F=5.107, p=.029) and climacteric symptoms(F=5.378, p=.025) of the middle-aged in rural community significantly decreased but blood triglyceride did not significantly decrease(F=2.737, p=.106) after the 16 weeks of the Korean dance program. It can be said that the Korean Dance Program, 'Harmony' is a useful implementation for improving rural middle-aged women's blood lipid and climacteric symptoms.

Psychometric evaluation of a Korean version of the 8‐item Medication Adherence Scale in rural older adults with hypertension

To examine the psychometric properties of a structured self-reported 8-item Korean-version Morisky Medication Adherence Scale (MMAS-K) among rural older adults with hypertension. Cross-sectional descriptive survey. A rural community comprising three primary health care posts in Gangwon Province, South Korea. Ninety-two older adults with hypertension who received treatment at primary health care posts. Participants completed an 8-item MMAS-K questionnaire, and the community health practitioners manually measured blood pressure. Factor analysis and correlation coefficient for validity and the Kuder-Richardson alpha coefficient for reliability of the MMAS-K were used, while the association between medication adherence and blood pressure control was determined using Fisher's exact test. Internal consistency reliability was acceptable with a coefficient alpha of 0.71. The factor analysis of construct validity identified two dimensions of the 8-item MMAS-K, explaining 52.22% of the total variance. There was a high correlation between the 8-item MMAS-K and the original 4-item MMAS (r = 0.874), indicating that these scales measure theoretically related constructs for convergent validity. There was a significant association between the 8-item MMAS-K score and blood pressure control (P < 0.05), indicating that, for the known-groups validity, the controlled blood pressure group was more likely to have higher rate of medication adherence than the poor-control group. The findings indicate a positive association between medication adherence and blood pressure control. The 8-item MMAS-K possesses adequate validity and reliability among rural older adults with hypertension.

Comparison of high- versus low-intensity community health worker intervention to promote newborn and child health in Northern Nigeria

BackgroundIn Northern Nigeria, infant mortality rates are two to three times higher than in the southern states, and, in 2008, a partnership program to improve maternal, newborn, and child health was established to reduce infant and child mortality in three Northern Nigeria states. The program intervention zones received government-supported health services plus integrated interventions at primary health care posts and development of community-based service delivery (CBSD) with a network of community volunteers and community health workers (CHWs), who focus on educating women about danger signs for themselves and their infants and promoting appropriate responses to the observation of those danger signs, consistent with the approach of the World Health Organization Integrated Management of Neonatal and Childhood Illness strategy. Before going to scale in the rest of the state, it is important to identify the relative effectiveness of the low-intensity volunteer approach versus the more intensive CBSD approach with CHWs.MethodsWe conducted stratified cluster sample household surveys at baseline (2009) and follow-up (2011) to assess changes in newborn and sick child care practices among women with births in the five prior years (baseline: n = 6,906; follow-up: n = 2,310). The follow-up respondents were grouped by level of intensity of the CHW interventions in their community, with “low” including group activities led only by a trained community volunteer and “high” including the community volunteer activities plus CBSD from a CHW providing one-on-one advice and assistance. t-tests were used to test for significant differences from baseline to follow-up, and F-statistics, which adjust for the stratified cluster design, were used to test for significant differences between the control, low-intensity, and high-intensity intervention groups at follow-up. These analyses focused on changes in newborn and sick child care practices.ResultsAnti-tetanus vaccination coverage during pregnancy increased from 69.2% at baseline to 85.7% at follow-up in the intervention areas. Breastfeeding within 24 hours increased from 42.9% to 59.0% in the intervention areas, and more newborns were checked by health workers within 48 hours (from 16.8% at baseline to 26.8% at follow-up in the intervention areas). Newborns were more likely to be checked by trained health personnel, and they received more comprehensive newborn care. Compared to the control communities, more than twice as many women in intervention communities knew to watch for specific newborn danger signs. Compared to the control and low-intensity intervention communities, more mothers in the high-intensity communities learned about the care of sick children from CHWs, with a corresponding decline those seeking advice from family or friends or traditional birth attendants. Significantly fewer mothers did nothing when their child was sick. High-intensity intervention communities experienced the most decline. Those who did nothing for children with fever or cough declined from 35% to 30%, and with diarrhea from 40% to 31%. Use of medications, both traditional and modern, increased from baseline to follow-up, with no differentiation in use by intervention area.ConclusionThe community-based approach to promoting improved newborn and sick child care through community volunteers and CHWs resulted in improved newborn and sick child care. The low-intensity approach with community volunteers appears to have been as effective as the higher-intensity CBSD approach with CHWs for several of the key newborn and sick child care indicators, particularly in the provision of appropriate home care for children with fever or cough.

Accessibility of health care service in Thasongyang, Tak Province, Thailand.

Accessibility to health care services in Thailand is generally good, but a few areas in the country are difficult to reach. The purpose of this study was to investigate the accessibility of health care services in rural and remote areas of Thailand. It was conducted in 16 remote villages within a catchment area with a primary health care post. The health care post staff interviewed 394 respondents (197 males and 197 females) using a structured questionnaire. Most respondents utilized primary health care posts (98.5%) and medical institutes. Most of the respondents were Karen, had low incomes, and were illiterate. However, they had health insurance. Most of them took more than 30 minutes to travel from home to their primary health care post (60.9%), and took more time in the rainy season than in the dry season. Moreover, it took more than 2 hours for them to travel to the nearest hospital from their residences (64.5% in the dry season and 84.5% in the rainy season). They also paid more for medical services, travelling and food on the way to the hospital. Not only primary health care posts, but also many other medical institutes provided health care services in the villages. In conclusion, based on the results of this study, primary health care posts in remote areas are necessary to ensure the residents' healthy lives. Therefore, improvement of the quality and accessibility of primary health care posts should be considered as the top priority.

Prescription Drug Use in Primary Health Care Posts and Its Improvement Scheme

Purpose: The prescription drug list for primary treatment by community health practitioners has been maintained for 30 years without any modification. Thus, this study will suggest an improvement scheme of prescription drug list for primary health care posts through an analysis of drug use in those posts. Methods: A questionnaire survey was implemented with community health practitioners from April to June in 2012. A total of 1,249 copies were analyzed. As for the databases of drug use in the integrated information, a total of 154,229 diagnoses selected in the method of stratified cluster sampling from 39 primary health care posts’data were analyzed. We consulted some experts about the prescription medication list, and referred to the medication information on-line home page for up-to-date drug information. Results: This study ultimately suggests 77 prescription drug items for primary health care posts by eliminating 35 items and replacing 1 item from the original list, and adding 4 items to it. Conclusion: This study will provide basic data for revising the prescription drug list in primary health care posts by periodically reflecting adverse effects in the existing drugs, demographic and environmental changes, and development of new drugs.

Self-Help Education as Outreach Program for Osteoarthritis Patients in Rural Korea

Purpose: This study was done to determine if osteoarthritis (OA) patients living in rural Korea would have a benefit from a structured group program focused on self-help strategies. Methods: A hundred and twenty-six patients with OA were recruited from nine Primary Health Care Posts. The experimental group received a 6-week self-help education program while the control group received usual care. T-tests and c2-tests were used to determine the homogeneity between the experimental and control groups. Independent sample t-tests were performed to determine the effect of the treatment program. To guard against such likelihood, the level of significance of t-test was determined by Bonferroni correction within the study constructs. When significant group differences were found in study variables at baseline, analysis of covariances (ANCOVAs) were used for group comparisons of outcome variables. Results: The experimental group reported more significant improvement in fatigue, difficulty with physical activity, depression, quality of life, self-efficacy, and health behaviors than did the control group. The experimental group also showed improvements in range of motion and muscle strength as compared to the control group. Conclusion: A self-help group education program was an effective and powerful strategy to promote physical and psychosocial health in OA patients

Awareness, Treatment and Control of Hypertension and Related Factors in the Jurisdictional Areas of Primary Health Care Posts in a Rural Community of Korea

This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP ≥ 140 mmHg, a diastolic BP ≥ 90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regularly taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.

The dilemma of over and under nutrition coexistence among western Kenya children.

Kenya can be considered a relatively better developed country among the sub-Saharan African ranks in terms of social services and yet malnutrition (under-nutrition) is still persistent and on the increase as shown in all nutrition and other surveys carried out in 1977, 1979, 1982, 1983 and 2003. Following these reports, a comprehensive survey was carried out in 2000 to explore all developmental and nutritional issues in Western Kenya, particularly the villages on the eastern shores of Lake Victoria. A comprehensive survey was carried out to explore any health/developmental issues that might have existed in this target group, particularly the school age children. Of the many developmental issues investigated, nutrition concerns were top priority. The analysis of the nutritional component of the survey confirmed coexistence of stunting and over-weight among the surveyed children. However, the impact was more pronounced in boys whereby their respective height- for- age indices were episodes of degenerative diseases like diabetes mellitus, coronary health diseases and hypertension. On the part of the parents and/or care-givers, about 57% were familiar with growth charts and their respective interpretations indicating more frequent visits to health care centres and posts. From the above findings it can be extrapolated that Kenyan infants/children at the surveyed area are in the midst of nutritional transition. Therefore, local authority’s intervention at this critical stage of the subject children’s life-cycle is needed to secure the desired child growth trajectory for better health outcomes.

방문보건사업 평가지표 개발

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

Malaria control in Vietnam: the Binh Thuan experience

The National Malaria Control Program (NMCP) in Vietnam is based on application of insecticide-treated bed nets (ITNs), spraying of insecticides and early microscopic diagnosis of malaria and treatment (EDTM) with artemisinin drugs. This study explores the implementation of the NMCP at provincial level and its impact on malaria incidence (mi) and prevalence in Binh Thuan in southern Vietnam. Data on implementation of EDTM, distribution of ITNs, annual mi and Plasmodium index (pi) were derived from intervention logbooks and surveillance records kept by the provincial Malaria Station since 1988. The relation between interventions and the change of pi over time was analysed with Generalized Estimating Equations. Control activities focused on the highly endemic zones where ITNs were distributed free of charge to ethnic minority groups, including twice yearly re-impregnation, from 1992 onwards. This almost completely replaced insecticide spraying. Complete ITN coverage of these groups was achieved in 1995, constituting 40% of the entire population. In all malaria endemic communes, primary health care posts were consecutively upgraded or installed, mainly between 1992 and 1995, offering EDTM with artemisinin drugs free of charge. Before 1994, mi peaked to over 50/1000, pi to over 16% in the highly endemic zones. In 1998, these had decreased to below 9/1000 and 4% respectively. The effects of the interventions could not be discerned with statistical significance. Malaria incidence and prevalence declined significantly in Vietnam, possibly due to the malaria control efforts, but coinciding with rapid socioeconomic changes.

Graduates in nursing: a report of a longitudinal study at the University of Hull.

A longitudinal study of the career paths of graduates in nursing from the University of Hull is in progress. The study uses a postal questionnaire, which is sent annually to each graduate. Data on the total sample of 99 graduates between 1981 and 1986 are summarized and discussed. All the graduates have registered as general nurses; 96% entered nursing practice. They tend to consolidate general nursing experience in hospital before obtaining further nursing qualifications and/or specializing. Over a period of some 4 years, a gradual shift away from hospital nursing to the community (especially health visiting), research and innovative health care posts can be observed. The findings of the Hull study confirm earlier findings from the Universities of Manchester, Edinburgh and Surrey that graduate nurses do enter and stay in nursing, that they seek further academic and nursing qualifications and that there is a shift towards work in the community.