Primary Health Care Institutions Research Articles

Knowledge of the Mothers toward Sanitation and Hygiene in relation to Childhood Gastroenteritis in Babylon Province

The negative impact of gastroenteritis in those aged 5 or less in Babylon Province in Central Iraq cannot beunderestimated as it is a serious impediment to the wellbeing and cognitive development of children anda cause of unnecessary death in this resource-strained region of the Middle Eastern country. In this regiondiarrhea is an important clinical presentation at primary health care institutions and other health affiliatedcentres, stands out as a leading cause of admission to many of the emergency hospital wards in Babylon,and a serious and ironically, often reversible cause of loss of precious lives. Regional attitudes in the MiddleEuphrates Region about causes that lead to childhood gastroenteritis vary from rural and urban localities andeven from townships, a cultural issue that is true for most provinces of Iraq.Aim of the study: 1-To study the social and demographic aspects related to sanitation and personal hygieneregarding childhood diarrhea in Babylon Province.2- To determine the local knowledge, of women and care givers about childhood diarrhea.Patients and methods: This cross sectional work was carried in Babylon Province, Iraq. A total 408respondents attending primary health care institutions and pediatric clinics for treatment of diarrhea , duringthe period from first of January 2019 to the first of May 2019.Results and Conclusions: In Babylon Province outbreaks of diarrhea tend to be noticed early in life priorto first year of life despite the fact that around three quarters of infants who contracted gastroenteritis werein compliance with Rota Vaccine timetable schedule. Seven out of ten women were fully knowledgeable ofthe importance immunization against Rota virus and its vital role in reduction of the risk of gastroenteritis.When their children contract diarrhea, a percentage shy of 66% said that they would seek paediatric medicalattention .Respondents whose infants were affected tend to be mostly urban, in their teenage years and lackedproper education. There is a remarkable lack of adequate knowledge about ways of contracting childhoodgastroenteritis.

Internet-based patient– primary care physician–cardiologist integrated management model of hypertension in China: study protocol for a multicentre randomised controlled trial

IntroductionThe control rate of hypertension is low in China, especially in rural, western and minority areas. This is related to poor medical skills among physicians in primary care institutions and...

Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015-2018.

Overuse of antibiotics has caused a series of global problems, especially in the underdeveloped western regions where healthcare systems are fragile. We used antibiotic procurement data of all healthcare institutions to analyze the total amount, patterns and trends of antibiotic use in Shaanxi Province, western China between 2015 and 2018. Antibiotic utilization was quantified using the standard Anatomical Therapeutic Chemical (ATC)/Defined daily dose (DDD) methodology. The World Health Organization’s “Access, Watch and Reserve” (AWaRe) classification and European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators were also adopted to evaluate the appropriateness and quality of antibiotic utilization. Overall, antibiotic consumption decreased from 11.20 DID in 2015 to 10.13 DID (DDDs per 1000 inhabitants per day) in 2016, then increased to 12.99 DID in 2018. The top three antibiotic categories consumed in 2018 were J01C (penicillins) 33.58%, J01D (cephalosporins) 29.76%, and J01F (macrolides) 19.14%. Parenteral antibiotics accounted for 27.41% of the total consumption. The largest proportion of antibiotic use was observed in primary healthcare institutions in rural areas, which accounts for 51.67% of total use. Consumption of the Access group, the Watch group, the Reserve group of antibiotics was 40.31%, 42.28% and 0.11%, respectively. Concurrently, the consumption of J01D and the percentage of J01 (DD + DE) (third and fourth generation cephalosporins) were at a poor level according to the evaluation of ESAC quality indicators. The total antibiotic consumption in Shaanxi Province had been on an upward trend, and the patterns of antibiotic use were not justified enough to conclude that it was rational. This is partly because there was high preference for the third and fourth generation cephalosporins and for the Watch group antibiotics.

The importance of introducing artificial intelligence to the medical curriculum – assessing practitioners’ perspectives

AimTo assess the attitude about the importance of introducing education on artificial intelligence (AI) in medical schools’ curricula among physicians whose everyday job is significantly impacted by AI.MethodsAn anonymous questionnaire was distributed at the national level in Croatia among radiologists and radiology residents practicing in primary, secondary, and tertiary health care institutions, both in the private and the public sectors. The overall response rate was 45% (144 of 321).ResultsA large majority of participants – 89.6% (95% Agresti-Coull confidence interval 0.83-0.94) agreed on the need for education on AI to be included in medical curricula. Answers revealed a very high support across age groups and regardless of subspecialty area. A slightly higher support was present among physicians working in university hospitals compared with those in primary care centers, and among radiology residents compared with radiologists – but these estimated differences are uncertain, and the support levels were clearly high across the considered variables.ConclusionSince medical students have previously been shown to support introducing education on AI, a growing literature argues the same for reasons here reviewed, and physicians practicing a highly relevant area (radiology) overwhelmingly agree, we conclude that medical schools should indeed take steps to keep pace with technological progress in medicine by including education on AI in their curricula, be it as part of existing or new courses.

Turnover intention among primary health workers in China: a systematic review and meta-analysis

ObjectivesTo analyse the prevalence and determinants of turnover intention (TI) among primary health workers (PHWs) in China to provide evidence for improving retention measures.DesignSystemic review and meta-analysis.Data sourcesFour English-language databases...

Evaluation of Patients’ Behavior with Bleeding Disorder in Preferring Primary Health Care Centre for Follow-Up and Treatment

Aim: The aim of this study is to examine the behaviors of patients who are members of the hemophilia association due to bleeding disorder, and due to health problems related to their diseases preferring primary health care institutions first, and to determine the reasons if they do not. Methods: The study was a descriptive cross-sectional study. The universe of the study was composed of hemophilia patients who are members of the hemophilia association living in Tekirdağ province (n=48). In the study face to face questionnaire was applied. People were asked about their first medical institutions in their complaints about their illness. The patients were asked about their age, gender, working status, educational status, types of bleeding disorders, severity and history of diseases. Results: Nobody preferred the primary health care institution for his complaints about bleeding disorder. Of the participants, 42.9% (n=18) stated that family physicians do not have sufficient information about this disease as the reason for not choosing primary health care institution. Conclusion: The trust of patients with bleeding disorders to family physicians is not sufficient. Regardless of the severity, type and prophylactic drug use of their disease, they do not prefer primary health care institution for their follow-up and treatment. Keywords: hemophilia, bleeding, family practice

Information technology and knowledge sharing for better health care: an emerging economy context

PurposeThe present study aims to explore “what” type of knowledge is shared, “how” it is shared and what information and communication tools are used to share knowledge among health-care professionals in the context of emerging “digital laggard” country in the South-Eastern European region (i.e. Bosnia and Herzegovina [B&H]).Design/methodology/approachThis study applies the qualitative research methodology and thematic analysis for collecting, analysing and interpreting data. Primary data is collected using semi-structured interviews (n = 9). Key informants are employees of the main primary health-care institution in the capital of B&H.FindingsThe results indicate that knowledge sharing among primary health-care practitioners is the interplay of formal and informal exchange of knowledge, facilitated by both traditional communication media (face-to-face interaction) and ICT-based tools. In regards to ICT tools, our findings suggest that instant messing applications (predominantly Viber) are viewed as common media for sharing tacit knowledge within a community of practice.Research limitations/implicationsThis study is limited to one emerging digital laggard country; thus, future research regarding ICT-based knowledge sharing in other emerging digital laggard countries is welcomed.Originality/valueIn the context of “digital laggard”, societies, informal, spontaneous and dynamic system of social interactions can be a successful substitute for ICT-based formalised and structured system of knowledge sharing.

Triage human papillomavirus testing for cytology-based cervical screening in women of different ages in primary hospitals: A retrospective clinical study.

Cervical cancer is a serious global health problem. The objective of this study was to provide a suitable cytology-based cervical screening method in women of different ages in primary hospitals.This study was a retrospective cohort study that included 9765 women who underwent primary cytology-based cervical screening and were grouped by age (35–44, 45–54, and 55–64 years old). Patients with abnormal cytology on the primary cervical thin-prep cytologic test (TCT) were advised to undergo triage human papillomavirus (HPV) test. Furthermore, patients with positive outcomes of the 2 indices underwent cervical tissue biopsy. The positive rate of TCT and HPV was compared among the 3 defined age groups. The sensitivity, specificity, and positive predictive value of TCT and HPV were assessed.In total, 2.5% (241/9765) of women had atypical squamous cells of undetermined significance or worse by TCT. High-risk (HR)-HPV infection was found in 70 triage participants. Neoplastic changes were confirmed in 95 patients (95/437, 21.7%) by biopsies. Among the different age groups, the positive rate of abnormal cytology was significantly different (P = .003), and the positive rate of HR-HPV was similar (P = .299). The sensitivity of initial TCT testing to detect intraepithelial neoplasia was higher than that of triage HPV testing, whereas the specificity, the positive predictive value of triage HPV testing was higher than that of TCT. The Youden index of HPV testing was higher than that of TCT detection in the 3 age groups, namely 0.582 versus 0.432, 0.553 versus 0.228, and 0.416 versus 0.332, respectively.The results of this study indicate that TCT testing is suitable as a cervical cancer screening method for women ≥35 years old in primary hospitals. Triage testing for women with HR-HPV has a high negative predictive value, reduces the rate of misdiagnosis, seems to be an excellent triage method for repeat atypical squamous cells of undetermined significance, and reduces the number of referral colposcopies preventing unnecessary overtreatment. The results of this study provide a crucial foundation for a unified guideline cervical cancer screening for primary health care institutions.

Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study

BackgroundPeople bypass primary healthcare (PHC) institutions to seek expensive healthcare at high-level hospitals, leading to escalating medical costs and inefficient use of resources. In 2009, China launched nationwide synergic policies on primary care strengthening, to tackle access to healthcare and financial protection. This study aimed to assess the impact of the two policy areas, health insurance and health workforce, on healthcare seeking behavior.MethodsDrawing on national survey data before (2008) and after (2013) the policies, we linked individual-level data on healthcare-seeking behavior with county-level data on health workforce and health insurance. We constructed a multilevel zero-inflated negative binomial regression to examine the impacts of average reimbursement rate (ARR) of health insurance and the density of registered physicians on outpatient/inpatient visits, and multilevel multinomial logistic regression for the impacts on choice of outpatient/inpatient care providers.ResultsAlthough the increase in health insurance ARR and physician density have positive impacts on individuals’ healthcare use, their impacts might be weakened during 2008 and 2013, and the negative impacts of investment of those in PHC institutions on likelihood of visiting hospitals was larger. The negative impacts of ARR at PHC institutions on likelihood of visiting county-, municipal- and higher-level hospitals in 2013 was 28 percentage points, 66 percentage points and 33 percentage points larger than these in 2008.ConclusionsPrimary care strengthening requires synergic policies. Effective mechanisms for coordination across multisectoral actions are necessities for deepening those policies to ensure efficient delivery of healthcare without experiencing financial risks.

Examining Nurses’ Theoretical Knowledge, Attitude, and Practice of Cardio-pulmonary Resuscitation in Hospitals and Primary Health Care Settings in South Sharqiyah, Sultanate of Oman

Objectives: This study attempts to identify the level of knowledge, attitude and practice of CPR among nurses in South Sharqyiah governorate, Oman. Moreover, it evaluates the association between the knowledge score and the selected variables. This will help to review the effectiveness of current CPR training, thus set up recommendations for better CPR programs. Method: This descriptive cross-sectional study was conducted between April and July 2019 in governmental hospitals and Primary Health care (PHC) institutions in Southern Sharqyiah Oman. A questionnaire-based survey was used to collect data from 282 registered staff nurses, including the Cardiopulmonary resuscitation (CPR) knowledge in both Basic Life support (BLS) and Advanced Cardiac Life support (ACLS), and nurses' attitude and practice towards CPR. Results: An excellent response rate of a total of 267 nurses (94.6%) took part in the study. Overall, nurses demonstrated inadequate level of knowledge in BLS their mean±SD of the total knowledge scores was 9.05±3.228. Like BLS knowledge, the participants demonstrated inadequate level of knowledge in ACLS as the total mean ±SD was 3.47±.1. 784. The study noted a significant association between the total scores of BLS knowledge and nationality (p=0.028). Conclusions: The result of this study has confirmed that knowledge of the nurses in BLS and ACLS was found to be low. The study revealed high numbers of staff nurses need to renew BLS and ACLS certificates. Thus, there is a crucial need for innovative educational interventions related to CPR. There is also a need to evaluate the knowledge and performance of CPR in clinical area such as mock drill.

Managing occupational stress: should we consider the sociodemographic groups of health workers?

Abstract Background An essential part of occupational stress management is identifying target groups and developing a wellbeing program that tailors organisational interventions to the specific needs of the target groups. The study aimed to explore whether psychosocial risk determinants and organisational intervention objects differ across employees' groups based on sociodemographic factors in a public healthcare institution. Methods Using a cross-sectional study design, paper questionnaires were delivered to all health workers (n = 690) of the Lithuanian primary healthcare institution; the response rate 68%. The questionnaire contained items related to sociodemographic groups (gender, age, job seniority, education, occupational status), 14 psychosocial risk determinants, and 10 organisational intervention objects. Nonparametric tests for comparisons of the groups were used. Results The results showed that differences by gender were not statistically significant except for one organisational intervention object. Only 3 organisational intervention objects had mean rank scores differing statistically across age and job seniority groups; 5 objects - across education groups and almost all objects - across occupational groups. Regarding psychosocial risk determinants, one determinant had mean rank scores differing statistically across age and job seniority groups; 4 and 6 determinants - across education and occupational groups respectively. Statistical significance was considered with p-value < 0.05 and 95% confidence interval. Conclusions The findings showed that different psychosocial risk determinants and organisational intervention objects were emphasized by different sociodemographic groups of health workers in the institution, but they did not impact groups in the same measure. Therefore, it is crucial to start by determining the risk group's specific needs before developing and implementing stress management programs. Key messages The study contributes to bridging the gap between theoretical knowledge and practical solutions in occupational stress management at public primary healthcare settings. The study has proposed a way of diagnosing psychosocial risks and of tailoring interventions to all health workers of the public primary healthcare institution by using a simple and robust tool.

Enjoying Breathing Program: A National Prospective Study Protocol to Improve Chronic Obstructive Pulmonary Disease Management in Chinese Primary Health Care.

BackgroundChronic obstructive pulmonary disease (COPD) is prevalent and poses a heavy burden worldwide. However, patients know little about COPD, and primary health care providers have poor therapy capability in China. Enjoying Breathing Program aims to establish a new comprehensive COPD patient management system, including early detection, standardized therapy, and follow-up in China. The goal of the study is to 1) describe the intervention for physicians and patients and 2) to assess the effectiveness of this program.MethodsIt is the first nationwide trial involving all levels of health care institutions from primary health care institutions to tertiary hospitals. It includes a series of structured but individualized intervention for both health care providers and COPD patients. Primary health care providers from pilot hospitals will take both online and face-to-face courses, including the procedure of COPD patients’ management and prevention, diagnosis and treatment. Once the patients are diagnosed with COPD, they will undertake standard therapy and self-management education program, perform rehabilitation exercises, and be followed up by primary health care providers every 3 months. The primary outcome will be exacerbation-related hospital/emergency admission and the change of patients’ awareness and primary health care providers’ knowledge of COPD within 36 months. Secondary outcome will include the change of pulmonary function test, structured COPD patients’ management, two-way referral, and standardized therapy.ConclusionA comprehensive COPD patient management model to promote the standardized therapy will be established; this will improve COPD patients’ awareness and health quality.Trial Registration NumberThis study has been registered at www.ClinicalTrials.gov (registration identifier: NCT04318912).

PNS22 Hospital Ownership and National Essential Medicines Policy: A Comparative Study between the Public and Private Primary Health-Care Institutions in Nantong, China

PNS22 Hospital Ownership and National Essential Medicines Policy: A Comparative Study between the Public and Private Primary Health-Care Institutions in Nantong, China

Birinci Basamak Sağlık Kuruluşlarında Örgüt Kültürü ve İşe Bağlanma Özelliklerinin Değerlendirilmesi, Zonguldak Merkez İlçe Örneği

Aim: Primary health care system is the most important organization of public health in terms of health service provision. Positive organizational culture and work engagement promotes service in the organization. The aim of this study was to evaluate the organizational culture and work engagement characteristics in primary health care institutions. To accomplish this goal, an organizational culture and work engagement scale was applied to healthcare professionals of the primary health care institutions. Material and Methods: In this cross-sectional study, organizational culture and work engagement scales were applied to 202 healtcare professionals who works in primary healtcare organizations in central district of Zonguldak. Results: 78.8% of the health professionals thought that the institution they served had the characteristics of a positive organizational culture. The most common types of organizational cultures were ‘hierarchical’ and ‘clan’ types. The evaluation of work engagement properties revealed that, doctors and those who did not work in managing units had higher work engagement scores. Hierarchical type of organizational culture was found to promote positive culture and work engagement. Healthcare professionals with positive organizational culture had higher total work engagement scores and the difference was significant. While the groups that adopted and didnot adopt the clan type organizational culture were not differentin terms of their work engagement, the points of vigor, dedication and absorption were higher among those who adopted the clan type organizational culture. Conclusion: This study was the first to evaluate the organizational culture and work engagement properties in primary health care institutions with the aspect of work organization in Zonguldak centered. Our study revealed that hierarchical type of culture promoted work engagement in workers and this finding was in accordance with the literature. The clan type, which is found with the second frequency, is different from the literature, but it draws attention to the social sharing dynamics in the team work in primary health care services. “team work” is an important principle in primary health care services organized by the “Socialization of Health Services” law and can explain the determination of clan-type organizational culture frequently. This study might lead other researchers to design new studies to evaluate the effects of work organization on services.

Factors Contributing to Patients' Preferences for Primary Health Care Institutions in China: A Qualitative Study.

Background: Primary health care (PHC) is a key component of the health care system in many countries. In China, however, PHC institutions are less preferred by patients, leading to the underuse of PHC services. Factors affecting patients' preferences for PHC institutions in China remain unreported in the current literature, which was first explored in this study.Method: A qualitative interview study was conducted in Nanjing, Jiangsu Province of China. A semi-structured interview guide was applied to ask patients' opinions regarding the PHC institutions in China. Qualitative data analysis was conducted using the thematic framework approach.Results: A total of 142 participants were interviewed. Three themes and their sub-themes emerged from the study: (1) attributes of PHC services, including accessibility of primary healthcare services, consultation time, drug cost, continuity of care, referral system, opening hours, waiting time, and drug accessibility; (2) attributes of PHC doctors' workforce, including doctors' attitude, competence, and accessibility; (3) attributes of PHC facility infrastructure, including basic facilities, diagnostic facilities and department settings. It was identified that some attributes of PHC services had positive impacts on participants' preferences for PHC institutions, while the same attributes of PHC doctors were the opposite.Conclusion: There are three major factors that contribute to patients' preferences for PHC institutions in China. Policy interventions to improve doctors' workforce and facility infrastructure of PHC institutions are needed to promote patients' preferences for PHC.

Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study.

Excess healthcare utilization is rapidly rising in rural China. This study focused on excess outpatient demand (EOD) and aimed to measure its performance and sociodemographic determinants among China’s rural residents. A total of 1290 residents from four counties in central China were enrolled via multistage cluster random sampling. EOD is the condition in which the level of hospital a patient chooses is higher than the indicated level in the governmental guide. A multilevel logistic regression was used to examine the sociodemographic determinants of EOD. Residents with EOD accounted for 85.83%. The risk of EOD was 51.17% and value was 5.69. The value of EOD in diseases was higher than that in symptoms (t = −21.498, p < 0.001). Age (OR = 0.489), educational level (OR = 1.986) and hospital distance difference (OR = 0.259) were the main sociodemographic determinants of EOD. Excess outpatient demand was evident in rural China, but extreme conditions were rare. Results revealed that age, educational level and hospital distance were the main sociodemographic determinants of EOD. The capacity of primary healthcare institutions, universality of common disease judgement and understanding of institution’s scope of disease curing capabilities of residents should be improved to reduce EOD.

Using affinity analysis in diagnosing the needs of patients as regards e-Health.

E-Health tools allow a medical facility to set a given patient's data in order using ICT techniques, and the patient to use those techniques when contacting a given organisation. Secondary statistical data was used in the research. The study was carried out among primary health care patients. Mining for affinity rules was done in the R programme. The apriori and inspect functions from the arules package were used. Moreover, any redundant rules were removed from thoseobtained using the afero-mentioned method. Applying the general description of the affinity analysis method onto the survey described herein, it should be stressed that the aim of using affinity analysis was to discover the rules which contain the sub-transaction B={V_6=1} as a consequent. This was determined by the intention to discover associations regarding the knowledge about a uniform information system that the patients under study might have. In the discovered rules, the antecedent most often contained an indication of the need for introducing a uniform solution as regards telemedicine. Moreover, according to the opinions of 'conscious'patients, a uniform IT system should improve the work at primary health care institutions, introducing an on-line booking system for visits should improve the productivity and comfort of doctors, and an IT system should provide unambiguous identification of a patient. There is potential in using affinity analysis within e-Health. The example of affinity analysis described in his study led to the discovery of interesting and important (from the point of view of a medical facility) regularities regarding the knowledge and expectations of patients as regards e-Health.

Investigation and analysis of standardized training for residents of general practitioners of Gansu Province in China

BackgroundChina’s standardized training for residents of General Practitioners (GPs) is aimed at providing the postgraduate training for family doctors who will serve the primary health care institutions. The aim of this paper is to investigate the standardized training situation, satisfaction with standardized training, work situation, intention, satisfaction and attitude of GPs who have finished standardized training.MethodsThis study was undertaken in 6 training hospitals in Gansu province using a questionnaire with 45 questions.ResultsApproximately 275 residents of GPs were enrolled. Finally, 263 residents completed the questionnaire (95.64% response rate), including 133 females (50.57%) and 130 males (49.43%) with an average age of 28 years (standard deviation, 1.93 years; range, 25–36 years). Additionally, 56.65% were single and 43.35% were married. Of all subjects, 92.40% residents had obtained certification of standardized training for residents of GPs and only 39.54% residents were satisfied with monthly income during training. There were 171 oriented rural medical graduates, of whom, only 42.69% expressed the willing to continue working in the primary health care institutions after the serve time (6 years) expired. Around 86.31% of residents of GPs who had finished standardized training got jobs with more than half serving in the primary health care institutions. For medical institutions and sanitary bureau were clear about general medicine policies, only 29.96% subjects registered as GPs. Among the residents in general practice department, 68.42% were engaged in the diagnosis and treatment of common disease and frequently-occurring diseases as well as referral of patients. The percentage of residents who were satisfied with the job and income were 30.40 and 14.98%, respectively.ConclusionStandardized training for residents of GPs in China is gradually improving. In order to cultivate more GPs and increase their willing to serve in the primary health care institutions, it is necessary to formulate and execute better policy of GPs, publize general medicine and improve the training quality.

Определение общего количества эндокринных нарушений среди детей с нарушениями речи: социально-диспетчерская работа

The article is devoted to determining the total number of endocrine disorders of the thyroid gland among children with speech disorders based on medical ultrasound data. The author of the article outlines that due to the fact that the prevalence of speech disorders is 100% among children with hypothyroidism, the following question deserves attention: “How many endocrine disorders can occur in children with speech disorders?”. Methods of research. Within the framework of the social and dispatching work of specialists of the psychological-medical-pedagogical commission, the referral of children with speech disorders to a medical ultrasound examination of the thyroid gland was organized. At the same time, none of the children had previously been examined by an endocrinologist or received appropriate treatment. The first group of children attended speech therapy classes at the Center for Psychological and Pedagogical Rehabilitation and Correction in Nizhneudinsk in the 2013-2014 academic year. The second group of children attended preschool educational institution №208 in the 2016-2017 academic year. The study allowed to draw the following key conclusions: in children with speech disorders in 40% of cases do have previously undetected endocrine disorders that deserve close attention and study by medical professionals, both of primary health care institution (Institute of Pediatrics) and pediatric endocrinologists; 29% of children with speech disorders potentially need the help of an endocrinologist. The algorithm for sending parents of children with speech disorders to consult medical specialists, whose help the child may need is presented in the article. The results of the study may be of interest to a wide range of medical and pedagogical specialists working in the system of school psychological and pedagogical councils, central and territorial psychological and medical and pedagogical commissions in the current conditions of the Federal State Educational Standards (FSES) implementation.

Frequency and correlates of violence against patients with schizophrenia living in rural China

BackgroundViolence against patients with schizophrenia is very common, however it is rarely studied in China, especially in primary health care institutions of rural areas. Therefore, we investigated the frequency of violence against patients with community-living schizophrenia in rural China and examined its associated factors and impact on quality of life (QoL) and social function.MethodA survey was conducted among 487 patients with schizophrenia living in rural communities. Data about violent victimization experiences in the past 6 months, demographic information, and clinical characteristics were collected by questionnaires.ResultsWe found that 92 (18.9%) of 487 subjects experienced at least one type of violent event in the past 6 months. Logistic regression analysis suggested that a history of conducting dangerous behaviors(OR = 1.702, P = 0.02, 95%CI: 1.05–2.73), higher Brief Psychiatric Rating Scale (anxiety domain) score (OR = 1.15, P = 0.02, 95%CI: 1.01–1.304) and lower hospitalization rates (OR = 0.89, P = 0.04, 95%CI: 0.81–0.99) were significantly associated with violent victimization in patients with schizophrenia. Analysis of covariance showed the victims of violence tended to have worse social function in patients with schizophrenia living in rural communities of China (P = 0.04).ConclusionsIndividuals with schizophrenia living in rural China had a high risk of being exposed to violence and violent victimization of patients with schizophrenia had adverse consequences for social function. More attention is needed for those patients experiencing violent events, because they are simultaneously possible to conduct dangerous behaviors.