Medicine Beliefs Research Articles

Constitutional Regulation of Speech (and False Beliefs) in Health Care.

False beliefs in medicine can be regulated by constitutional doctrines of false speech and professional speech, whereby government can restrict professionals' false beliefs or impose its own false beliefs on professionals. In our allegedly "post truth" society, such regulations and their foundations can have an important influence on health care practice.

Using the extended self-regulatory model to characterise diabetes medication adherence: a cross-sectional study

ObjectivesTo cluster the adherence behaviours of patients with type 2 diabetes based on their beliefs in medicines and illness perceptions and examine the psychosocial, clinical and sociodemographic characteristics of patient...

Association of Medication Beliefs, Self-efficacy, and Adherence in a Diverse Cohort of Adults with Rheumatoid Arthritis.

Rheumatoid arthritis (RA) patients' adherence to disease-modifying antirheumatic drugs (DMARD) is often suboptimal. We examined associations among medication beliefs, self-efficacy, and adherence to medications in RA. Data were from a longitudinal observational cohort of persons with RA. Subjects completed telephone interviews on self-reported adherence, self-efficacy, demographics, and the Beliefs about Medicines Questionnaire (BMQ), which assesses beliefs in necessity and beliefs about taking medication. Bivariate and multivariate logistic regression identified correlates of poor adherence to synthetic DMARD and prednisone as well as to biologic therapy, including medication concerns and necessity. There were 362 patients who reported taking a synthetic DMARD and/or prednisone. Of these, 14% and 21% reported poor adherence to oral DMARD or prednisone, and biologics, respectively. There were 64% who reported concern about taking medicines, 81% about longterm effects, and 47% about becoming too dependent on medicines. In multivariate analyses, the BMQ necessity score was independently associated with better adherence to oral DMARD or prednisone (adjusted OR 0.61, 95% CI 0.41-0.91), while self-efficacy was associated with greater odds of poor adherence to oral medications (adjusted OR 1.23, 95% CI 1.01-1.59). Beliefs in medicines and self-efficacy were not associated with adherence to biologics. In a diverse cohort of patients with RA, stronger beliefs in the necessity of medication were associated with better adherence to oral DMARD or prednisone, while higher self-efficacy was associated with poor adherence. Providers can play important roles in eliciting patient beliefs about medications to improve adherence and ultimately health outcomes.

Impact of "Sambhav" Program (Financial Assistance and Counselor Services) on Hepatitis C Pegylated Interferon Alpha Treatment Initiation in India.

Background: Financial constraints, social taboos and beliefs in alternative medicine are common reasons for delaying or not considering treatment for hepatitis C in India. The present study was planned to analyze the impact of non-banking interest free loan facility in patients affected with hepatitis C virus (HCV) in North India. Methods: This one year observational, retrospective study was conducted in Department of Gastroenterology (January 2012-December 2013), Dayanand Medical College and Hospital Ludhiana, to evaluate the impact of program titled "Sambhav" (which provided non-banking financial assistance and counselor services) on treatment initiation and therapeutic compliance in HCV patients. Data of fully evaluated patients with chronic hepatitis, and/or cirrhosis due to HCV infection who were treated with Peginterferon alfa and ribavirin (RBV) combination during this duration (2012- 2013) was collected from patient medical records and analyzed. In the year 2012, eligible patients who were offered antiviral treatment paid for treatment themselves, while in 2013, ‘Sambhav’ program was launched and this provided interest free financing by non-banking financial company (NBFC) for the treatment of HCV in addition to free counselor services for disease management. The treatment initiation and compliance rates were compared between the patients (n = 585) enrolled in 2013 who were offered ‘Sambhav’ assistance and those enrolled in 2012 (n = 628) when ‘Sambhav’ was not available. Results: Introduction of Sambhav program improved the rates of treatment initiation (59% in 2013 vs. 51% in 2012, P=.004). Of the 585 eligible patients offered ‘Sambhav’ assistance in 2013, 233 patients (39.8%) applied but 106/233 (45.4%) received assistance. Antiviral therapy was started in 93/106 (87.7%) of these patients, while only 52 (42.5%) of 127 patients whose applications were rejected underwent treatment. Compliance to antiviral therapy also improved with the introduction of ‘Sambhav’ program (87.7% vs. 74.1%, P=.001). Conclusion: ‘Sambhav’ program had significant impact on the initiation of antiviral therapy by overcoming the financial hurdles. The free counselor services helped to mitigate social taboos and imparted adequate awareness about the disease to the patients. Initiatives like ‘Sambhav’ can be utilized for improving healthcare services in developing countries, especially for chronic diseases.

Postpartum Maternal Health at a Time of Rapid Societal Change in Abu Dhabi, United Arab Emirates

Background. Abu Dhabi has undergone a rapid transition from a subsistence economy to a wealthy modern state over the last 50 years. This paper presents an insight into the health status of Emirati mothers during this transition through a prospective longitudinal study of mothers who gave birth in a government maternity hospital in the Emirate of Abu Dhabi.Methods. 125 women were interviewed within the first week after birth, as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health. They were then re-interviewed at three, six and 15 months postpartum. A food frequency questionnaire was also administered to the mothers at birth. Data were analysed using univariate statistics.Results. Over 70% of the mothers had BMI in the overweight and obese categories, and approximately half of the women were dissatisfied with their weight. Contributing factors were likely to be diets high in fats and sugar, low levels of exercise and women’s limited involvement in household food purchasing and preparation. Iron deficiency anaemia, diabetes, asthma and fertility problems were found to be the most common concerns amongst the participants prior to conception. Anaemia rates were high during pregnancy, with 35% having haemoglobin < 11 g/dL, and were positively associated with parity. Belief in traditional and herbal medicines was strong, with 43% of women using a variety of remedies during pregnancy.Conclusions. Policies and support mechanisms to encourage women to make better dietary choices and to provide more opportunities for exercising are required to improve the health of mothers in the UAE. The development of good quality health care has resulted in the better maternal health outcomes, although traditional practices in relation to herbal medicines are still common.

Complementary and alternative medicine beliefs and complementary medicine use in Australians with type 2 diabetes: The Fremantle Diabetes Study Phase II

The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR-associated (Cas) system is an adaptive immune system in bacteria and archaea that resists exogenous invasion through nucleic acid-mediated cleavage. In the type III-A system, the Csm complex contains five effectors and a CRISPR RNA, which edits both single stranded RNA and double stranded DNA. It has recently been demonstrated that cyclic oligoadenylates (cOAs), which are synthesized by the Csm complex, act as second messengers that bind and activate Csm6. Here, we report the crystal structures of Staphylococcus epidermidis Csm3 (SeCsm3) and an N-terminally truncated Csm6 (SeCsm6ΔN) at 2.26 and 2.0 Å, respectively. The structure of SeCsm3 highly resembled previously reported Csm3 structures from other species; however, it provided novel observations allowing further enzyme characterization. The homodimeric SeCsm6ΔN folds into a compact structure. The dimerization of the HEPN domain leads to the formation of the ribonuclease active site, which is consistent with the reported Csm6 structures. Altogether, our studies provide a structural view of the ribonuclease activity mediated by Csm3 and Csm6 of the type III-A CRISPR-Cas system.

Bioprospecting of South African Plants as a Unique Resource for Bioactive Endophytic Microbes.

South Africa has a long history and strong belief in traditional herbal medicines. Using ethnobotanical knowledge as a lead, a large number of South African medicinal plants have been discovered to possess a wide spectrum of pharmacological properties. In this review, bioprospecting of endophytes is highlighted by following the advantages of the ethnomedicinal approach together with identifying unique medicinal plants where biological activity may be due to endophytes. This review focuses on the current status of South African medicinal plants to motivate the research community to harness the benefits of ethnobotanical knowledge to investigate the presence of endophytic microbes from the most potent South African medicinal plants. The potential chemical diversity and subsequent putative medicinal value of endophytes is deserving of further research. A timely and comprehensive review of literature on recently isolated endophytes and their metabolites was conducted. Worldwide literature from the last 2 years demonstrating the importance of ethnobotanical knowledge as a useful approach to discover endophytic microbes was documented. Information was obtained from scientific databases such as Pubmed, Scopus, Scirus, Google Scholar, Dictionary of Natural Products, Chemical s Services, official websites, and scientific databases on ethnomedicines. Primary sources such as books, reports, dissertations, and thesises were accessed where available. Recently published information on isolated endophytes with promising bioactivity and their bioactive natural products worldwide (2015-2017) was summarized. The potential value of South African medicinal plants as sources of endophytes is discussed. The insights provided through this study indicate that medicinal plants in South Africa are highly under-investigated sources of potentially useful endophytic microbes. New approaches may be used by medicinal plant scientists for further exploration of natural products from endophytic fungi and bacteria in southern Africa.

Regular medical checkup behaviour: preventing is better than curing

PurposeThe purpose of this paper is to investigate the factors that drive or impede the intention of Indonesian consumers to perform regular medical checkup (MCU).Design/methodology/approachThis study begins with an ethnographic study to ascertain the determinant factors that motivate or hinder an individual from performing regular MCU. The study involved stakeholders in various health services providers, including patients and medical professionals. The quantitative part of this study focuses on “preventive” segment of consumers. A survey was conducted covering 303 respondents, consisting of two sub-segments of people labelled “healthy lifestyle” and “unhealthy lifestyle”.FindingsConsumer behaviour with regards to needs for MCU must be categorised not based on demographics, but their health status – preventive or curative. The “preventive” group was found to have differences in triggers and barriers between the healthy vs unhealthy lifestyle subgroups. For the “healthy lifestyle” subgroup, the determining factors for a regular MCU are the perceived benefit of action, social deviance, and cost perception. For the “unhealthy lifestyle” subgroup, the determining factors for a regular MCU are the social deviance, disease heritage, belief in traditional medicine, no urgency and cost perception.Research limitations/implicationsThe qualitative study part indicated the differences between two segments: preventive vs curative. The quantitative study part is only conducted in the preventive segment and not covering the curative segment. It would be interesting to see the differences between these two segments.Practical implicationsImplication of study: to create contextual marketing communication in each stakeholders/segments – to reach the marketing objectives. Different segment has different issues to handle and need a different marketing communication programme.Originality/valuePrevious studies have focused on analysing the differences in groups based on their demographics, which does not illustrate a homogenous need for an MCU. This study contributes by addressing that researchers must differentiate between “preventive” and “curative” groups. Additionally, the study of triggers and barriers has interestingly found that the determinant factors for healthy and unhealthy lifestyle are not the same.

Factors associated with elderly diabetic adherence to treatment in primary health care.

This study aimed to investigate factors associated with the treatment adherence of 150 elderly diabetics assisted in gerontogeriatric outpatient service in northeastern Brazil. Full adherence to therapy was self-reported by 27.3% of the elderly. In the bivariate analysis, adherence was associated with self-perceived health, beliefs in the use of medication, understanding explanations about diabetes and professional responsible for treatment guidance. After analysis adjustment, only beliefs in medicine were significant when comparing non-adherence with full adherence (OR = 9.65; CI95% 1.6; 56.6) and non-adherence with partial adherence (OR = 18.15; CI95% 3.5;95.4). It can be concluded that full adherence to diabetes treatment is low and is associated with beliefs in medications for disease control. It is necessary to develop additional studies to better define the role of health beliefs and practices of care among elderly assisted in primary health care.

A systematic review of the traits and cognitions associated with use of and belief in complementary and alternative medicine (CAM)

Complementary and alternative medicine (CAM) use is widespread despite the controversy over its effectiveness. Although previous reviews have examined the demographics and attitudes of CAM users, there is no existing review on the traits or cognitions which characterise either CAM users or those who believe in CAM effectiveness. The current systematic review set out to address these gaps in the literature by applying a narrative synthesis. A bibliographic search and manual searches were undertaken and key authors were contacted. Twenty-three papers were selected. The trait openness to experience was positively associated with CAM use but not CAM belief. Absorption and various types of coping were also positively associated with CAM use and belief. No other trait was reliably associated with CAM use or belief. Intuitive thinking and ontological confusions were positively associated with belief in CAM effectiveness; intuitive thinking was also positively associated with CAM use. Studies researching cognitions in CAM use/belief were mostly on non-clinical samples, whilst studies on traits and CAM use/belief were mostly on patients. The quality of studies varied but unrepresentative samples, untested outcome measures and simplistic statistical analyses were the most common flaws. Traits and cognition might be important correlates of CAM use and also of faith in CAM.

Identifying and Addressing Genetic Counseling Challenges among Indigenous People of Oaxaca\u2014One Center\u2019s Experience with Two Immigrant Farmworker Families in the Central Valley of California

An important aspect of genetic counseling is the recognition of and adaptation to the socio-cultural uniqueness of the different populations that a genetics clinic serves. The Central Valley of California is home to a large population from Mexico, with a significant proportion of indigenous ancestry originating from the state of Oaxaca. We report on our experience with two families of this community—one extended family with an early lethal inborn error of metabolism and the other with a chronic disfiguring form of ichthyosis. We identified multiple important factors that needed to be considered, including the matching of language dialects, adaptation to different social interaction conventions, acknowledgement of traditional medicine beliefs, and effective transmission of genetic terms and concepts, all of which should be incorporated into the interactions with these families when aiming to provide comprehensive genetic counseling.

The association of health literacy with illness perceptions, medication beliefs, and medication adherence among individuals with type 2 diabetes.

Beliefs in medications and illness perceptions is associated with medication adherence among individuals with diabetes and several adherence interventions focus on patients' beliefs in medicines and illnesses. Though health literacy is important in medication adherence, the relationship between health literacy and medication adherence remains inconclusive; thus raising the question as to whether health literacy has an amplifying or reducing effect on the relationship between beliefs and adherence. The study examined (1) the association between health literacy, beliefs in medicines, illness perceptions, and medication adherence in individuals with type 2 diabetes and (2) the moderating effects of health literacy (including numeracy and document literacy) on the relationship between illness perceptions, beliefs in medicines, and medication adherence. Adults ≥20 years taking oral diabetes medicines at two family medicine clinics, completed a cross-sectional survey. Participants were assessed on beliefs in medicines, illness perceptions, health literacy, self-efficacy, and medication adherence. Multiple linear regressions examined the effect of health literacy, beliefs and self-efficacy, and the moderator effect of health literacy in the relationship between beliefs and adherence. Of the 174 participants, more than half were women (57.5%) and white (67.8%). There was a significant positive association between self-efficacy and adherence (β = 0.486, p < .001), and a negative association between threatening illness perceptions and adherence (β = -0.292, p < .001). Health literacy had a significant moderator effect on the relationship between adherence and concerns beliefs (β = -0.156, p = .014) and threatening illness perceptions (β = 0.196, p = .002). The concern beliefs - adherence association was only significant at marginal and adequate literacy levels. When health literacy was separated into numeracy and document literacy, only numeracy moderated the illness perceptions - adherence relationship (β = 0.149, p = .038). Health literacy, especially numeracy, needs to be initially addressed before diabetes adherence interventions that address individual concerns about medicines and threatening illness perceptions can work.

Author Reply.

The comments of the editor truly reflect the findings of our study on the surgical treatment of giant penoscrotal lymphedema. All the 19 patients described in the study were to be treated by surgery. Eight patients, however, defaulted, possibly because of their belief in alternative traditional herbal medicine and or financial constraint, because health insurance schemes are yet to be fully established in our environment.

Cancer Impact, Complementary/Alternative Medicine Beliefs, and Quality of Life in Cancer Patients.

The purpose of this study was to explore the relationships among cancer impact, belief in complementary and alternative medicine (CAM), CAM use, and quality of life (QOL). The study used a cross-sectional, descriptive correlational design with convenience sampling. A total of 122 cancer patients participated. Data were collected at a medical center in Chunghua, Taiwan. The questionnaires included the Chinese version of the Cancer Problem in Living Scale (CPILS), Complementary and Alternative Medicine Belief Inventory (CAMBI), Complementary and Alternative Medicine scale, and Chinese versions of QOL scales, including the Functional Assessment of Cancer Therapy-General (FACT-G). The mean age was 56.5 years, and most participants were male (n = 69, 56.6%), had completed high school or above (n = 56, 45.9%), and were married (n = 109, 89.3%). The most common type of cancer was oral (n = 17, 13.9%), followed by esophageal (n = 15, 12.3%) and colorectal (n = 13, 10.7%). Cancer patients, on average, use one or two types of CAM. The impact of cancer is significantly related to age (F = 7.12, p < 0.05), and income is related to QOL (F = 3.61, p < 0.05). Pearson correlations showed that the use of CAM was positively associated with belief in CAM (CAMBI) (r = 0.26, p = 0.01), and the impact of cancer was highly negatively associated with QOL (r = -0.71, p = 0.001). The predictors of QOL were the impact of cancer and use of CAM, and the impact of cancer accounted for 51% of the variance in QOL. This study supports research on the impact of cancer, belief in CAM, and use of CAM as related to QOL in cancer patients. These results can be used to provide options to clinicians and cancer patients.

Communication disability in Fiji: Community self-help and help-seeking support

Purpose: To understand how a Fijian community supports people with communication disability (PWCD) and whether their support is associated with participant demographics.Method: Thematic analysis of 144 questionnaires that asked about participants’ actions to support a fictional child and adult with communication disability.Result: Participant responses fell into two categories: what they would do directly (self-help) and people and places where they would seek assistance (help-seeking). Self-help behaviours included: making a change to their own communication style or mode; trying to change their own and others’ behaviour; teaching new skills; praying; changing the physical environment; seeking information independently; assessing or observing; and, using traditional medicine, western medicine, or traditional belief practices. Help-seeking behaviours included seeking help from: other community members; education professionals; a professional in another country; spiritual leaders; traditional belief practitioners; traditional medicine practitioners; western health care practitioners; or, an alternative provider (e.g. home, orphanage, nursing home). Younger participants and those of iTaukei Fijian ethnicity were more likely to seek help from other community members.Conclusion: This Fijian community actively supports people with communication disability within available networks. Development of speech-language pathology services for people with communication disability living in similar communities should harness the informal knowledge within these networks.

Influence of patient perceived relationship with pharmacist and physician and its association with beliefs in medicine

Objectives The purpose of this study was to evaluate the association between patients’ perceived relationship with their pharmacist and physicians and its association with their beliefs in medicine. Methods A cross-sectional design was used and 307 self-administered surveys were collected from adults, 45 years and above, in Houston, Texas via convenience sampling. Participants reported their general beliefs in medicine (perceived harm, perceived benefit and perceived medication overuse), perceived patient–pharmacist relationship, and perceived patient–physician relationship using a previously validated instrument adapted for this research. Perceived relationship constructs consisted of three domains each for pharmacist and physicians, namely trust/satisfaction, information sharing and patient involvement in treatment. Key findings The study participants were white (46.25%) females (54.72%) with a mean age of 58 (±13) years. The results indicate that the participants trusted and were satisfied with both their pharmacist and physician. Participants with higher trust/satisfaction with pharmacist consider medications as more beneficial. While participants with higher trust/satisfaction with their physicians were less likely to believe that doctors over-prescribe medicines, which may lead to medication over use. Information sharing by pharmacists was associated with a significant decrease in perception of general benefits of medications. Further participant's involvement in treatment decisions by the physician had a significant association with increased perceptions of benefits of medications. Conclusions Patients trust/satisfaction with their pharmacist leads to the belief that medications are more beneficial while a higher trust/satisfaction with physicians leads to lower beliefs in medicine, especially patients less likely to be adherent with appropriate medications.

Ethno-medicinal Practices among Pattharkatta Kanjars in Lucknow District of U.P.

Present paper depicts the picture of ethno-medicinal knowledge bank prevailed in Pattharkatta Kanjars, a primitive and nomadic community of gypsies and hunters of Lucknow district. The use of traditional medicine system is found among them which occupy its own place along with the modern allopathic and other system of medicines. They follow ethno-medicines and have faith on them with varying number of herbs and plants from place to place. Younger generation do not have enough belief in these alternate medicines; however, they either do not discard them, their use depends on their interest and kind of need. This is an exploratory-cum-objective-based study whose purpose is to find out the use of traditional medicines for the remedies of diseases in their community. It employs traditional field exploration, interview schedule, photographic method and others. Data is collected through primary as well as secondary sources including official government websites with random and purposive sampling method.

Use of complementary and alternative medicines in Indian elderly patients

Background: Use of complementary and alternative medicine (CAM) is more common in elderly patients due to the prevalence of various age-related chronic medical conditions. The pharmacokinetics and pharmacodynamics change with age and are different in the elderly as compared to a young adult. Non-disclosure of CAM usage voluntarily by the patients, along with the practice of poly-pharmacy for various comorbidities and concurrent use of modern medicine with CAM, makes this age group particularly prone to adverse effects of drugs and the drug–drug interactions. Use of CAM assumes further importance in the context of Indian elderly, due to the widespread belief in traditional medicines and easy over-the-counter availability of many prescription drugs in India. Aims and Objective: The study was conducted to understand and analyze the knowledge, attitude, and perception of CAM usage specifically in elderly Indian patients, which to the best of our knowledge has yet not been assessed previously. Materials and Methods: It was a descriptive cross-sectional study assessing a representative sample of 325 elderly patients over the age of 60 years. Data collection was done after face-to-face interview-based survey administered on a semi-structured questionnaire. Results: The number of CAM users (65.5%) was significantly more than the non-users (P ≤ 0.05). In the age group between 60 and 69 years, 59% had used CAM, as compared to a significantly more number of 76% patients (P ≤ 0.05), in the age group above 70 years. The CAM practice in the elderly was not influenced significantly by gender, education, rural or urban background, and distance from the health-care facility of modern medicine system. CAM was the initial choice of therapy for 65.7% of the users. Ayurveda was the most popular practice (64.8%), followed by homeopathy (62.4%) with many patients using both the practices together. Use of CAM practices concomitantly with modern medicine was not considered unsafe by 56.8% of patients. The physicians of modern medicine did not ask 91.5% of elderly patients about CAM usage and 85.5% of patients did not volunteer any information on CAM usage unless asked for. Conclusions: The study suggests the need to acknowledge and explore the high prevalence of CAM usage with increasing age in the Indian elderly, both to identify the irrational usage of CAM alone or in combination with the modern medicine system and to facilitate the integration of rational CAM practices in the mainstream medicine.

Fizjologia i rozrodczość kobiety w pismach Metodego z Olimpu i Ambrożego z Mediolanu

Topics concerning women’s physiology and reproduction appear relatively rarely in the reflections of the Fathers of the Church. Most often they perpetuated the beliefs of ancient medicine, benefitting from the appropriate terminology. The originality of their reflection lies in trying to use the “scientific” facts within theo­logical considerations (eg the creation of mankind and the Incarnation of the Son of God) and moral ones (eg the value of sexuality, fertility and parenthood). The scope of this article includes analysis of selected texts of Methodius of Olympus and those of Ambrose of Milan. Both authors had a deep medical knowledge of the issues and their works contain interesting examples related to female repro­ductive physiology. They were protagonists of an ideal of virginity, but yet, they preserved a positive assessment of fertility and marriage. Worthy of particular emphasis, in the works of Methodius, is the defense of the dignity of every unborn child, whom God himself creates and animates in the womb. The basis of the con­siderations in Symposium was a passage from Genesis 2: 21-24, to which he gave allegorical meaning, defining human sexuality and procreation as the typology of the divine and ecclesiastical realities. In turn, Ambrose undertook issues such as conception, prenatal development and the birth of a child, in the context of the exceptional role of Mary in the history of salvation and in the Incarnation of the Son of God. Theological considerations were an excellent opportunity for him to express moral teaching and pastoral care, and to provide very practical and help­ful, medical and educational tips for women.

Implementing Team-Based Care: It's Our Duty

Implementing Team-Based Care: It's Our Duty