Health Counseling Services Research Articles

Advancing Student Health and Achievement Through Medicaid: Lessons Learned from State Efforts to Expand Medicaid-Funded School Health Services.

ABSTRACTBACKGROUNDSchool health services improve health and academic outcomes; however, sustainable funding for these services is an ongoing struggle. In December 2014, the Centers for Medicare & Medicaid Services clarified how Medicaid will reimburse school health services. School districts, once restricted to reimbursement for services delivered under specific conditions, can now receive Medicaid reimbursement for eligible services delivered to all Medicaid‐enrolled students.METHODSThis article examines the literature exploring school health services' impact on health and academic outcomes and Medicaid's role in funding school health services. The article analyzes state, school‐based Medicaid policies and programs and the impact of the federal policy change.RESULTSAs of August 2020, 13 states have used the federal policy change to expand their school‐based Medicaid programs to include all eligible services delivered to all Medicaid‐enrolled students.CONCLUSIONSThis policy change creates an opportunity for states and school districts to leverage health care funding to implement multiple components of the Whole School, Whole Community, Whole Child model, including health services, counseling, psychological and social services, employee wellness, and school climate. The federal policy change can also improve health equity by increasing reimbursement for school districts serving higher percentages of Medicaid‐enrolled students.

Home visiting: A lifeline for families during the COVID-19 pandemic

Home visiting: A lifeline for families during the COVID-19 pandemic

The Mental Health Impact of the COVID-19 Pandemic: Implications for Sub-Saharan Africa.

The COVID-19 pandemic is leading to mental health problems due to disease experience, physical distancing, stigma and discrimination, and job losses in many of the settings hardest hit by the pandemic. Health care workers, patients with COVID-19 and other illnesses, children, women, youth, and the elderly are experiencing post-traumatic stress disorders, anxiety, depression, and insomnia. Virtual mental health services have been established in many settings and social media is being used to impart mental health education and communication resources. This rapid review highlights mental health services across countries hardest hit by the COVID-19 pandemic. More needs to be done to take these services to scale and ensure equity and efficiency. The impact of COVID-19 on mental health in sub-Saharan Africa could be immense, given the weak health care systems. Similar to the Ebola epidemic of 2014–2016, COVID-19 is expected to cause anxiety, depression and post-traumatic stress disorders. Uptake of mental health care services is generally low, and communities rely on social resources. Hence, efforts to control the disease transmission should be contextualized. Low digital literacy, low smartphone penetration and limited internet connection make online mental health services a limited option for service delivery. Safeguarding social and cultural resilience factors and coping mechanisms is critical in the sub-Saharan African context. Mass media is a feasible way of providing social resources. Community health workers can be trained quickly to provide mental health education, screening and counselling services. Toll-free mental health helplines can be used to provide services to health care workers and those needing customized care. Mental health and psychosocial support services need to be integrated into the pandemic response and coordinated nationally. It is critical for these services to continue during and after the epidemic.

Genetic testing and employer-sponsored wellness programs: An overview of current vendors, products, and practices.

BackgroundEmployer‐sponsored corporate wellness programs have spread despite limited evidence of effectiveness in improving health or reducing costs. Some programs have offered genetic testing as a benefit to employees, but little is known about this practice.MethodsIn December 2019, we conducted a systematic Google search to identify vendors offering corporate wellness programs involving genetics. We performed qualitative content analysis of publicly available information about the vendors’ products and practices disclosed on their websites.ResultsFifteen vendors were identified. Details regarding genetic testing offered within wellness programs were difficult to decipher from vendors’ websites, including which specific products were included. No evidence was provided to support vendor claimed improvements in employer costs, employee health, and job performance. Only half offered health and genetic counseling services. Most vendors were ambiguous regarding data sharing. Disclaimer language was included in vendors’ stated risks and limitations, ostensibly to avoid oversight and liability.ConclusionWe found a lack of transparency among corporate wellness program vendors, underscoring challenges that stakeholders encounter when trying to assess (a) how such programs are using genetics, (b) the potential benefits of such applications, and (c) the adequacy of protections to ensure scientific evidence support any health claims and genetic nondiscrimination.

The Effect of Interactive Educational Workshops With or Without Standardized Patients on the Clinical Skills of Midwifery Students in Providing Sexual Health Counseling.

Insufficient skills among health personnel, including midwives, can lead to failure in evaluating and providing sexual health counseling services to clients. Thus, the purpose of this study was to compare the effect of 2 interactive educational workshops with or without standardized patients (SPs) on midwifery students' clinical skills in providing sexual health counseling at Mashhad University of Medical Sciences, Mashhad, Iran, in 2014 to 2015. In this randomized controlled trial, 62 midwifery students were selected through convenient sampling method and then randomly divided into 2 groups who received 1 of 2 interactive educational workshops, with or without SPs in 10-hour educational programs. The students' skills in providing sexual health counseling were evaluated before and 2 weeks after the education through an Objective Structured Clinical Examination composed of 5 stations using validated checklists. The data were then analyzed using the SPSS Software (Version 16) through descriptive statistics as well as independent t test, paired t test, Mann-Whitney U, χ, and Fisher exact tests. The level of significance was considered by P < 0.05. There was no significant difference between the mean scores of students' clinical skills in providing sexual health counseling services in the group educated with or without SPs (22.4 ± 7.0 and 23.0 ± 9.4, P = 0.77). However, 2 weeks after the interventions, the mean scores were 75.8 ± 11.2 and 47.0 ± 8.9, respectively, meaning a significant difference between the study groups (P < 0.0001). Although both teaching methods could promote clinical skills among the midwifery students, the effect of interactive workshop with SPs was much significantly stronger.

The Challenges of Public Health, Social Work, and Psychological Counselling Services in South Korea: The Issues of Limited Support and Resource.

Public health, social work, and psychological counselling professions in South Korea are facing challenges of human resource shortage and shortage of professionals who can provide multilingual services. The purpose of this study was to explore and understand why public health, social work, and psychological counselling services degree graduates and professionals with multilingual skills in South Korea decide to leave their professional field to the hospitality and business industries, particularly for those who completed their initial training at one of the international universities. Based on the approach of the Social Cognitive Career Theory, individuals’ self-efficacy, outcome expectations, interests, and goals were examined and considered. The data were collected from 12 participants with the methodology of interpretative phenomenological analysis. The general inductive approach was employed to categorize the themes for reporting. The results indicated that public health, social work, and psychological counselling services-related positions are not available, modelling from peers, and lack of career development skills are the primary difficulties of public health, social work, and psychological counselling services graduates. The completion of this study provides clear recommendations to educators, policymakers, school leaders, human resource planners, and university administrators to improve their curricula and school counselling for public health, social work, and psychological counselling services graduates and the next generation.

Exposure to General Anesthesia for Cesarean Delivery and Odds of Severe Postpartum Depression Requiring Hospitalization.

Previous research suggests that, compared with regional anesthesia, general anesthesia is associated with increased odds of postoperative depressive disorders. No study has specifically evaluated the possible protective effect of neuraxial anesthesia for cesarean delivery on maternal mental health compared with general anesthesia. This exploratory study was designed to test the hypothesis that general anesthesia for cesarean delivery is associated with increased odds of severe postpartum depression (PPD) requiring hospitalization compared with neuraxial anesthesia. This retrospective cohort study included cesarean delivery cases performed in New York State hospitals between January 2006 and December 2013. Exclusion criteria were as follows: (1) having >1 cesarean delivery during the study period; (2) residing outside of New York State; (3) having a general anesthetic for other surgery or delivery in the previous year or in the year after the index case. The primary outcome was the occurrence of PPD, and the secondary outcomes were: (1) the composite of suicidal ideation or self-inflicted injury (ie, suicidality); (2) anxiety disorders; and (3) posttraumatic stress disorders (PTSD). Primary and secondary outcomes were identified during the delivery hospitalization and up to 1 year after delivery. Adjusted odds ratios (aORs) and 95% confidence interval (CI) of adverse psychiatric outcomes associated with general anesthesia were estimated using propensity score matching. Of the 428,204 cesarean delivery cases included, 34,356 had general anesthesia (8.0%). Severe PPD requiring hospitalization was recorded in 1158 women (2.7/1000; 95% CI, 2.5-2.9); of them, 60% were identified during readmission, with a median of 164 days after discharge. Relative to neuraxial anesthesia, general anesthesia in cesarean delivery was associated with a 54% increased odds of PPD (aOR, 1.54; 95% CI, 1.21-1.95) and a 91% increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95% CI, 1.12-3.25). There was insufficient evidence in these data that general anesthesia was associated with anxiety disorders (aOR, 1.37; 95% CI, 0.97-1.95) or PTSD (aOR, 1.50; 95% CI, 0.50-4.47). General anesthesia for cesarean delivery is associated with increased odds of severe PPD requiring hospitalization, suicidal ideation, and self-inflicted injury. If confirmed, these preliminary findings underscore the need to avoid the use of general anesthesia for cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to general anesthesia.

Do gay and bisexual men who conceal their same-sex behavior prefer different kinds of health services? Findings across four cities to inform client-centered HIV prevention in China

BackgroundIn China, addressing disparities in the HIV epidemic among men who have sex with men (MSM) requires targeted efforts to increase their engagement and retention in prevention. In an effort to advance MSM-friendly HIV services within China, and informed by community-based partnerships, we tested whether MSM who have ever versus never disclosed their same-sex behavior to healthcare providers (HCP) differ in sociodemographic and behavioral characteristics as well as the qualities of sexual health services each group would prefer to access.MethodsWe conducted a cross-sectional survey among HIV-negative MSM who went to MSM-focused voluntary counseling and testing clinics in four cities in China. The survey was anonymous and collected information on sociodemographic characteristics, testing behaviors, sexual-health related behavior, and sexual health service model preferences.ResultsOf 357 respondents, 68.1% participants had ever disclosed same-sex behavior to HCPs when seeking advice for sexual health. Younger age (aOR = 1.04; 95% CI: 1.01-1.08), and worry of HIV acquisition (aOR = 1.39; 95% CI: 1.05–1.84) were associated with higher odds of past disclosure. The availability of comprehensive sexual health services was one of the most valued characteristics of the ideal sexual health clinic. Those who ever disclosed and never disclosed differed significantly in their ranking of the importance of three out of ten dimensions: sexual health counseling services available (M = 3.99 vs. M = 3.65, p = .002), gay identity support available (M = 3.91 vs. M = 3.62, p = .016) and clinic collaborates with a gay CBO (M = 3.81 vs. M = 3.56, p = .036).ConclusionsOur hypothesis that MSM who had disclosed versus never disclosed same-sex behavior would differ in the value they placed on different dimensions of sexual health service was partially borne out. As health authorities in China decide on implementation models for pre-exposure prophylaxis (PrEP) delivery and specifically within which institutions to integrate PrEP services, the preferences of target populations should be considered to develop comprehensive, patient-centric and LGBT-friendly services.

Effect of perceived social support on stress, anxiety and depression among Nepalese nursing students

High levels of stress, anxiety and depression can adversely influence physical health, psychological well-being, academic and clinical performance of the nursing students. Social support serves as a buffer against life stressors and improves individuals' psychological well-being. The aim of this quantitative cross-sectional study was to examine the effect of perceived social support on stress, anxiety and depression among Nepalese nursing students. A descriptive cross-sectional study was done among 680 female nursing students enrolled for Bachelor of Science in Nursing program in nine colleges in Kathmandu valley. Depression Anxiety Stress Scale-21 was used to assess the levels of depression, anxiety and stress, whereas perceived social support was measured using Multidimensional Scale for Perceived Social Support. About half the proportion of students reported moderate to extremely severe levels of stress (47%). Majority reported moderate to extreme anxiety (72.9%) and depression (51.7%). Most students perceived high-level social support (68.9%) from family, friends and significant others. A one-way multivariate analysis of variance revealed that perceived social support had a significant effect on stress, anxiety and depression among Nepalese nursing students (Wilks' ƛ = 0.97, F (3, 676) = 8.1, P 0. 000). A discriminant analysis indicated that depression demonstrated the strongest relationship (0.95) with perceived social support contributing to the significant overall effect. The study revealed a strong relationship of perceived social support with stress, anxiety and depression among nursing students. Although most students reported high level of perceived social support, they experienced high levels of stress, anxiety and depression. Hence, the college administration should take the initiative to introduce and implement periodic mental health screening, counselling and referral services.

Opinions of Students in the Field of Health About the Sexuality of Individuals with Disability

Sexuality is an important aspect of quality of life, but it is also an area where problems often cluster in individuals with disabilities. Attitudes towards the sexual life of people with disabilities may make it difficult for them to find solutions to their problems, meanwhile increasing their problems. This study aimed to determine the opinions of students who will provide health counseling services in the future on the sexuality of people with disabilities. A total of 498 university students (83.8% of the target population) in the field of health submitted verbal consent for participating in this descriptive study. The items that the students agreed on the sexuality of people with disabilities and the distributions of the percentage of the items were as follows: “Do you think that the sexuality of people with disabilities is overlooked, ignored, or suppressed in society?” (57.5%); “Do you think sexual health is an important aspect affecting the life quality of people with disabilities?” (52.1%); “Do you think the interruption of sexual activity in people with disabilities is due to social and psychological factors rather than biological and physical factors?” (52.6%); and “Do you think that sexuality is often neglected when the history of patients with disabilities is taken in healthcare institutions?” (49.1%). On the other hand, the items that the students disagreed on were as follows: “Do you feel uncomfortable when answering questions on sexuality?” (45.0%); “Will you give sex education if you get the necessary education?” (44.4%); and “Is sexual education given in school and family sufficient?” (62.8%). Also, only 11.2% of the students were found to have knowledge of sexuality in people with disabilities. The results of this simple descriptive study can contribute to the development of health care services and the educational curriculum on the sexuality of people with disabilities.

Process Evaluation of Training Model for School-Based Mental Health

There is a need to examine collaborative mental health practices in geographic regions serving high populations of under-represented minority and low socio-economic status youth in order to reduce the barriers in access to care and support. In response, a counselor education program at a large land-grant university in the Southwestern United States worked in collaboration with a local school district to create a school-based mental health program. The program provides no-cost and timely mental health counseling services to students and their families using a practicum training model. This article presents process evaluation data that examine program level functioning during the implementation stage of the training model. Implications for program improvements in the next phase of implementation are discussed as well as implications of this type of service delivery model within the context of counselor education and social justice.

Integrated Behavioral Health in Rural Settings: A Course Design

ABSTRACTRurality is a vital component of cultural diversity, making it essential to train future counselors on comprehensive mental health counseling practice with rural populations. In this article, we describe the development of a master’s level course that reflects an integrated approach to providing mental health counseling services in rural communities. First, the pedagogical foundation for the course design and positionality are discussed. Second, the course objectives are outlined, and corresponding teaching methods and creative learning assignments are provided. Last, we discuss the strengths and challenges of the course design and implementation.

Kecakapan Hidup Terkait Kesehatan Reproduksi pada Siswa SMA di Kabupaten Tabanan

Background: The adolescence period is a critical period in which physical, psychological and intellectual growth is very rapid, so it is prone to fall into risky behavior. Risk behaviors of adolescents in Indonesia include drug and alcohol use, as well as premarital sex, which can increase the number of cases of HIV/AIDS infection. To respond to adolescent reproductive health problems, the government has launched the PIK-R Program. The goal is to provide reproductive health information and counseling services, maturation of marital age, life skills, gender and advocacy skills and IEC. Life skills education for adolescents is very important to support the development of individuals to become responsible adults. To live an orderly life, individuals need the skills people need to do things regularly.&#x0D; Method: This study used a cross sectional design. Respondents in this study were 150 students who participated in the PIK-R Program which came from three high schools in Tabanan Regency. Samples were taken by purposive sampling. Data collection is done by survey using a questionnaire.&#x0D; Results: The study showed that Life Skills related to reproductive health in high school students who participated in the PIK-R Program were mostly in the good category, which was 116 people (77.33%). The PIK-R program has a positive impact on adolescent life skills related to reproductive health

Improvement of Quality of Antenatal Care (ANC) Service Provision at the Public Health Facilities in Lao PDR: Perspective and Experiences of Supply and Demand Sides

BackgroundThe maternal mortality rate in Lao PDR (Laos) is still the highest in Southeast Asia, at 197 per 100,000 live births. Antenatal care (ANC) could contribute to maternal and child mortality reduction. The quality of ANC service remains inadequate and little information is available on the quality of health education and counseling services of health providers in Laos. This study aims to gain insight into the perceptions of stakeholders on both supply and demand sides of public ANC services in Laos and evidence for recommendations to improve the quality of ANC services.MethodsSemi-structured interviews were conducted with 50 participants from different stakeholder groups; on the demand side, couples with a currently pregnant woman and mothers with children under one year of age and a family member; and on the supply side, health providers, managers, policy makers of the Ministry of Health, and development partners. The interviews were voice recorded and transcribed verbatim for analysis by open and thematic coding, using the MAXQDA software program.ResultsAll respondents reported that the number of pregnant women who visit ANC services has increased. However, an analysis of the supply side identified issues related to the quality of ANC that need to be improved in the areas of facilities, human resources, privacy and confidentiality, providers’ behavior, attitudes, and ineffective communication skills when it comes to providing health education and counseling to pregnant women and their family members. The analysis of the demand side mainly emphasized the issues of providers’ behavior, attitude, communication and unequal treatment, and the lack of privacy. Both sides also suggested solutions to the problems, such as training, effective materials, rewarding good role models, and building a feedback system.ConclusionThe number of public ANC services has increased, but both supply and demand sides experienced challenges with the quality of ANC. All respondents proposed possible solutions to improve quality of ANC service in public health facilities in Laos.

Sosialisasi Program Mobil Curhat di Kota Bogor Tahun 2015–2017

Nutrition counseling is used as one of the strategies to improve nutritional status and reduce the risk of metabolic syndrome through information transfer about balanced diet. As part of the community service program, Faculty of Human Ecology, IPB University collaborated with Bogor Municipality Health Office launched a mobile health counseling services in July 2014 to increase access to health services in Bogor, Indonesia, which includes nutrition counseling, detection of non-infectious diseases, HIV detection, and family counseling. The service runs across areas in Bogor city two to three times per month, attracted approximately 50 visitors per run. The program aimed to identify the nutritional status of visitors of mobile health counseling services. Primary data collected in this program were obtained using interview and direct measurement. Counseling was initiated by obtaining age and body height data through interview, while the body weight, Body Mass Index (BMI), and total body fat was measured using a portable body composition analyzer. Based on data collected between March 2015 and November 2017 (n = 1769) showed that majority of visitors were female (61.8) with largest age group were 40 to 49 years old (23.6) followed by age group of 50 to 59 years old (20.9). Half of the clients (50.4) have a normal nutritional status (BMI 18.5–25 kg/m2), but more than half (61.3) had a percentage of total body fat above normal value. Although the results have not been able to describe the nutritional status profile of Bogor residents, it can be a reference in formulating a nutrition program suitable for healthy populations.

Health-Related Quality of Life Profiles among Patients with Different Road Traffic Injuries in an Urban Setting of Vietnam.

Road traffic injuries (RTIs) cause a substantial disease burden in Vietnam. Evaluating health-related quality of life (HRQOL) among patients having a diversity of RTIs informs an integral part of treatment effectiveness. This study aims to examine HRQOL of patients suffering different RTIs in Vietnam’s urban areas. A cross-sectional study was conducted on 408 patients from October to December 2018 in six hospitals in Thai Binh. The EuroQol-5 dimensions-5 levels (EQ-5D-5L) and visual analog scale (VAS) were used to assess the HRQOL of patients. Multivariable Tobit regression was applied to measure the difference of HRQOL among different kinds of injuries. The mean EQ-5D-5L and VAS score was 0.40–0.66, respectively. Mean EQ-5D-5L index was lowest in patients with oral and facial injuries (0.22) and fracture injuries (0.23), while patients having hand injuries had the highest EQ-5D-5L index (0.54). EQ-5D-5L index had a negative association with oral, facial, and fracture injuries. Meanwhile, patients with brain, fracture, and multiple injuries tended to have lower VAS score. Poor HRQOL among patients injured in road traffic were observed. Pain management, early rehabilitation, and mental health counseling services should be considered during treatment time, especially among those having the brain, oral and facial trauma, fracture, and multiple injuries.

Consistent Condom Use and Associated Factors among HIV-Positive Clients on Antiretroviral Therapy in North West Ethiopian Health Center, 2016 GC.

Background The burden of Human Immune Deficiency Virus or Acquired Immune Deficiency Syndrome is high in sub-Saharan countries including Ethiopia which have over two-thirds of the global HIV burden. Many would argue that consistent condom use is not most effective method for HIV prevention. Condoms offer protection against unwanted pregnancy and some sexually transmitted infections including Human Immune Deficiency Virus, when used correctly and consistently. Inconsistent use of condom by People Living with Human Immune Deficiency Virus or Acquired Immune Deficiency Syndrome on Antiretroviral Therapy will lead to further worsening the Human Immune Deficiency Virus infection epidemic and reinfection with new drug resistant viral strains. Objective To assess magnitude of consistent condom use and associated factors among HIV-positive clients on Antiretroviral Therapy in North West Ethiopian health center, 2016 GC. Method An institutional based cross-sectional study was conducted, from April 15 to June 10, 2016. A total of 358 patients on ART in Koladiba Health Center had participated in this research. Koladiba Health Center is the first health center in Ethiopia that is found in Debbie district, which is located in north Gondar Zone. Study participants were selected by simple random sampling technique. Data were collected by using pretested structured questionnaires and analyzed using SPSS version 22. Descriptive statistics was computed and binary and multiple logistic regressions were also conducted to examine the effect of selected independent variables on consistent condom use. Result A total of 358 ART clients participated in the study with response rate of 90%. Among study participants, 138 (38.5%) were in the age category of 35-44 years. About 216 (60.3%) of the participants were female and 325 (90.8%) were Orthodox followers. Consistent condom use was reported by 130 (55.8%) sexually active study subjects. Respondents in rural residence (AOR=0.326, 95% CI: 0.109, 0.973) and sexual partner initiated condom use (AOR=0.031, 95% CI: 0.005, 0.186) were found to be the independent predictors of consistent condom use. Conclusion and Recommendations Consistent condom utilization among HIV clients on ART was low (55.8%). Place of residence and condom use initiation during sexual contact were significantly associated with consistent condom use. It is better to give more emphasis on health education and counseling service about consistent condom use for PLWHA who are on ART during follow-up especially for those who came from rural areas.

Layanan Konseling Kesehatan Untuk Meningkatkan Psychological Well Being Mahasiswa

University is not only a place where students get knowledge academically but also non-academically. It must show responsibility to give students the opportunity to have a good life. For this reason, university must help students to be aware of their self, their purpose in life and passion. It must help students develop their potential so they can live happily (well being especially psychological well being). The life satisfaction and happiness (psychological well being) can be fulfilled if the individual is in good health. The World Health Organization defines health as being physically, mentally and socially healthy. Health counseling can help individualsoptimize their potential. Continuous efforts to maintain body fitness, manage emotion and thinking ability for giving positive interpretation in life experinces and harmony social interaction and mutual support to others make individuals feel satisfied in life and happy. The purpose of this activity is to provide health counseling services to increase students' psychological well being. Thirty students from various faculties at UnikaSoegijapranata were involved in this activity. By attending three health counseling sessions with the theme of physical, mental, and social health there was an increase in psychological well being.

College Students’ Attitudes Toward Counseling for Mental Health Issues in Two Developing Asian Countries

This study examines 300 college students in Iran and China. It clarifies that students from China have more positive attitudes toward counseling than those from Iran using a quantitative survey with well-established existing scales in the literature. The regression tests show different indictors for college students’ attitudes toward mental health counseling in these two developing countries. Anticipated risk has been found as the most negative and powerful predictor of attitudes toward counseling in Iran. Stigma has been found as the most negative and powerful predictor of attitudes toward counseling in China. Implications have been discussed for educational departments and governments to advocate positive evaluations on mental health counseling services.

The Effects of Service Characteristics of Maritime Telemedicine on Seafarer’s Satisfaction and Loyalty

The objective of this study was to analyze the effect of characteristics of maritime telemedicine (service quality, recognition or not of service, health counselling service experience or not) on seafarer‘s satisfaction, and also analyze the effect of seafarer’s satisfaction on loyalty. This study’s data was collected from the Research Report of Survey of telemedicine service subjects in 2017 conducted in the maritime telemedicine pilot project. However, only 103 seafarers who received maritime telemedicine (Tele-Monitering) services were analyzed statistically. The main results of this study were as follows. ⅰ) Better service quality led to higher levels of satisfaction, ii) High levels of seafarer’s satisfaction led to high levels of loyalty, iii) Seafarers whose age is under 50 than 30 years old are less satisfied, ⅳ) In total boarding career, Seafarers with more than 5 years but less than 10 years were more satisfied than seafarers with less than 5 years, ⅴ) Seafarers with more than 10 years but less than 15 years were more satisfied than seafarers with less than 5 years, ⅵ) Seafarers with more than 15 years but less than 20 years were more satisfied than seafarers with less than 5 years, ⅶ) Also, Seafarers in excess of 20 years were more satisfied than seafarers with less than 5 years, In conclusion, ⅰ) Better service quality led to higher levels of satisfaction and loyalty. Accordingly, the improvement of service quality is not only an important factor in improving satisfaction and loyalty, but also plays an important role in forming a positive image of maritime telemedicine. ⅱ) Seafarers with younger age and lower overall total boarding career were more satisfied. It is believed that the seafarer who are willing to use telemedicine and who are willing to refer to others are young.