Reasons For Seeking Treatment Research Articles

Patient-centred evaluation of satisfaction levels following orthognathic surgery: results over a 4-year period, and implications for the futures

Assessing patient outcomes guides our surgical practice. In order to determine our performance as an orthognathic service, our standardised survey was used to explore the patient's motivations, expectations and experience of treatment. The survey was carried out on an annual basis, addressing 53 parameters of care in 7 subsections based on the patient journey. The response rate averaged 70% per year. 103 patients were surveyed in total, over 4 years. Reasons for seeking treatment (straighter teeth, better appearance) remained constant.

REASONS FOR SEEKING DENTAL TREATMENT FOLLOWING TRAUMA TO ANTERIOR TEETH AMONG ADULTS IN A LOW- INCOME ECONOMY

Background: Anterior teeth which primarily are the incisors and canine teeth contribute significantly to a satisfactory smile and human appearance. However, they are more likely to be traumatized when trauma is experienced in the facial region. Patient may seek dental attention or treatment immediately or much later due to a variety of reasons including pain, sensitivity, tooth mobility and aesthetic considerations due to tooth substance loss and/or discoloration. Objective: To review the reasons for seeking dental treatment following trauma to anterior teeth from subjects' perspective and the time of presentation and the distribution patterns of the above. Materials and Methods: This was a retrospective study of all adult patients who presented with trauma to the anterior teeth between June 2010 and December 2012 at the University of Benin Teaching Hospital, Benin City, Edo State. Simple descriptive analysis was used to characterize the subjects' demographic characteristics, history of the trauma, time elapsed between trauma and presentation and reasons for seeking treatment. Results and conclusion: There were 221 cases of trauma to the anterior teeth giving an average of 7.34 cases presenting per month. Subjects' ages ranged from 17- 69 years with a mean of 29.7 ± 11.0 years. About half of the subjects (48.4%) sought treatment for aesthetic concerns (discoloration and disfigured teeth). Pain was the main concern in about one third (35.3%) of the subjects. Over one third of the subjects presented within the first month of injury, while almost half of the subjects (49.7%) presented within the first year. The mean time elapsed between injury and presentation among the subjects was 6.84±8.5years. There was statistically significant association between time elapsed and the reasons for seeking treatment. Aesthetic consideration was found to be the most common reason for seeking treatment, health education efforts should be include

Patient expectations before arthroscopic shoulder surgery: correlation with patients’ reasons for seeking treatment

Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measures and patients' reasons for seeking treatment. We prospectively collected and retrospectively analyzed data from patients before elective arthroscopic shoulder surgery for a wide range of pathologic processes. Preoperative subjective data included QuickDASH scores, pain and functional components of the American Shoulder and Elbow Surgeons (ASES) score, and mental and physical components of the SF-12 score. Expectations data were collected and grouped on the basis of the reasons for seeking of medical treatment and ranked according to their relative importance. The study included 313 shoulders. There were 205 men and 108 women with a mean age at surgery of 48.7 years (range, 18-78 years). Overall, the most important expectations were for the "shoulder to be back to the way it was before the problem started" and to continue participation in sporting activities. Patients who presented with the "shoulder coming out" had fewer important expectations than did those who presented for other reasons. Those patients who indicated a desire to continue participation in sports had significantly less pain (improved ASES pain scores) compared with the rest of the population. Although return to sport was the most important expectation overall, the importance of other expectations varied by patients' reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability. Level III, cross-sectional design, epidemiology.

Factors associated with receipt of residential rehabilitation by opiate users indicate that these clients are more amenable to drug treatment

Aims: Residential rehabilitation (RR) is relatively expensive and is received by a minority of drug users seeking treatment. It is perceived to be particularly effective, but those entering RR may be more amenable to treatment than those treated in other modalities. The objective of this study was to explore ways in which opiate users treated in a residential setting differ, at treatment entry, from those treated in a community setting. Methods: Opiate users (N = 406) who received either RR or community substitute prescribing (CSP) were sampled from the UK Drug Treatment Outcomes Research Study (DTORS). A logistic regression analysis, controlling for Drug Action Team, was used to predict the occurrence of RR versus CSP for the treatment of opiate dependence. Measures included self-reported levels of drug use, offending, social measures and health. Findings: RR clients were different to CSP clients in a number of respects that may positively influence treatment outcome; most importantly, their reasons for seeking treatment were different and they were better motivated. Conclusions: Higher treatment motivation may be one factor that explains why RR is a more effective treatment for clients with complex drug-related problems.

Women's motivators for seeking treatment for alcohol use disorders

This study examined types of internal and external motivations for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change.

Sociodemographic and substance use characteristics of gamma hydroxybutyrate (GHB) dependent inpatients and associations with dependence severity

BackgroundThe number of admissions to addiction treatment centers in the Netherlands for gamma hydroxybutyrate (GHB) dependence is rapidly growing. Until now, treatment seeking GHB users have hardly been studied. This study characterizes inpatients in treatment for GHB dependence in terms of sociodemographics, motives for substance use and reasons for seeking treatment. In addition, variables associated with dependence severity are identified. MethodsPatients were recruited by their therapists at 4 different addiction treatment centers dispersed throughout the Netherlands. They were asked to fill out the questionnaire, including sociodemographic and clinical characteristics, GHB and other drug use, and a modified version of the Drug Use Disorders Identification Test (DUDIT) to screen for GHB dependence. The associations of relevant variables with dependence severity were determined using multiple regression analysis. ResultsA total of 75 inpatients (response rate 90.4%) participated in the study. Most patients were young (mean 26.8±9.1) males (73%) with low education (78%) and not employed (48%). Most of them (75%) had started using GHB the year before treatment admission, 42 (56%) frequently combined GHB with sedatives and 26 (35%) frequently combined GHB with stimulants. Dependence severity was strongly associated with sleep problems and the combined use of GHB and stimulants. ConclusionThis study shows that sociodemographic characteristics of GHB inpatients are similar to those of problematic users of other club drugs. Sleep problems and combined use of GHB and stimulants were strongly associated with GHB dependence. Together, these factors might help to better identify people at risk for GHB dependence.

Pressure to Reduce Drinking and Reasons for Seeking Treatment

Individuals with alcohol problems often receive pressure to change their drinking. However, when they enter treatment it is unclear how often it is because of the pressure they received or other reasons. A secondary analysis was conducted using four cross sectional National Alcohol Surveys (NASs) collected at 5-year intervals between 1995 and 2010. Treatment seekers (N=476) were interviewed about 1) all reasons for seeking treatment, 2) their primary reason, 3) lifetime heavy drinking, and 4) whether they ever received pressure from six different sources (spouse, family, friends, doctor, work and police). Over 90% of the sample received pressure from at least one source. Thirty-four percent identified legal problems/felt forced as their primary reason for seeking treatment. Other primary reasons included a desire to improve relationships (25%) and health (15%). When asked about all reasons, 46% endorsed five or more reasons and 74% included legal problems/felt forced. When pressure was received from police it was often the primary reason for seeking treatment. When pressure was received from physicians or work, legal problems/felt forced was less likely to be the primary reason. Most reasons, including legal problems/felt forced, did not change significantly over time. A primary reason for seeking alcohol treatment is drinking-related legal problems or feeling forced. However, legal problems/feeling forced occurs along with a variety of additional reasons. Future research should assess pathways between receipt of pressure from different sources, recognition of different types of problems, and reasons given for seeking treatment.

Characterization of individuals seeking treatment for caffeine dependence.

Previous investigations have identified individuals who meet criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 years, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts), and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment and suggests that there is a need for effective caffeine dependence treatments.

A Qualitative Exploration of Individuals’ Motivators for Seeking Substance User Treatment

Substance abuse continues to greatly impact the US population. The purpose of this study is to improve understanding of the reasons why individuals seek substance user treatment. Qualitative interviews were conducted with 50 men (n = 25) and women (n = 25) across eight substance user treatment programs in Durham, North Carolina, in 2010. We identify six motivating themes regarding reasons for seeking treatment and explore how these themes vary by the participants’ mode of entry into treatment. Findings provide a holistic understanding of how and why individuals come into treatment that can enhance the quality and impact of substance user services.

Evaluation of a Standardized Morbidity Surveillance Form for Use during Disasters Caused by Natural Hazards

Surveillance for health outcomes is critical for rapid responses and timely prevention of disaster-related illnesses and injuries after a disaster-causing event. The Disaster Surveillance Workgroup (DSWG) of the US Centers for Disease Control and Prevention developed a standardized, single-page, morbidity surveillance form, called the Natural Disaster Morbidity Surveillance Individual Form (Morbidity Surveillance Form), to describe the distribution of injuries and illnesses, detect outbreaks, and guide timely interventions during a disaster. Traditional data sources can be used during a disaster; however, supplemental active surveillance may be required because traditional systems often are disrupted, and many persons will seek care outside of typical acute care settings. Generally, these alternative settings lack health surveillance and reporting protocols. The need for standardized data collection was demonstrated during Hurricane Katrina, as the multiple surveillance instruments that were developed and deployed led to varied and uncoordinated data collection methods, analyses, and morbidity data reporting. Active, post-event surveillance of affected populations is critical for rapid responses to minimize and prevent morbidity and mortality, allocate resources, and target public health messaging. The CDC and the Georgia Department of Public Health (GDPH) conducted a study to evaluate a Morbidity Surveillance Form to determine its ability to capture clinical presentations. The form was completed for each patient evaluated in an emergency department (ED) during triage from 01 August, 2007 through 07 August, 2007. Data from the form were compared with the ED discharge diagnoses from electronic medical records, and kappa statistics were calculated to assess agreement. Nine hundred forty-nine patients were evaluated, 41% were male and 57% were Caucasian. According to the forms, the most common reasons for seeking treatment were acute illness, other (29%); pain (12%); and gastrointestinal illness (8%). The frequency of agreement between discharge diagnoses and the form ranged from 3 to 100%. Kappa values ranged from 0.23-1.0, with nine of the 12 categories having very good or good agreement. With modifications to increase sensitivity for capturing certain clinical presentations, the Morbidity Surveillance Form can be a useful tool for capturing data needed to guide public health interventions during a disaster. A validated collection instrument for a post-disaster event facilitates rapid and standardized comparison and aggregation of data across multiple jurisdictions, thus, improving the coordination, timeliness, and accuracy of public health responses. The DSWG revised the Morbidity Surveillance Form based on information from this study.

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in typical practice settings. In a representative survey (from June 2008 to September 2009) 1,212 subjects who received outpatient psychotherapy during the past 6 years were questioned about their experiences with outpatient psychotherapy via telephone interviews. Socio-economic data, reasons for seeking treatment, access paths, financial resources and psychosocial support data were collected. Therapeutic settings and modalities and concomitant medication treatment are described. The findings illustrate the problem of multiple psychiatric morbidity in the clinical practice and confirm the urgent need for patient access to professional psychotherapeutic services. Improving access to these services requires close cooperation between care providers.

Cross border reproductive care in six European countries

The quantity and the reasons for seeking cross border reproductive care are unknown. The present article provides a picture of this activity in six selected European countries receiving patients. Data were collected from 46 ART centres, participating voluntarily in six European countries receiving cross border patients. All treated patients treated in these centres during one calendar month filled out an individual questionnaire containing their major socio-demographic characteristics, the treatment sought and their reasons for seeking treatment outside their country of residence. In total, 1230 forms were obtained from the six countries: 29.7% from Belgium, 20.5% from Czech Republic, 12.5% from Denmark, 5.3% from Slovenia, 15.7% from Spain and 16.3% from Switzerland. Patients originated from 49 different countries. Among the cross border patients participating, almost two-thirds came from four countries: Italy (31.8%), Germany (14.4%), The Netherlands (12.1%) and France (8.7%). The mean age of the participants was 37.3 years for all countries (range 21-51 years), 69.9% were married and 90% were heterosexual. Their reasons for crossing international borders for treatment varied by countries of origin: legal reasons were predominant for patients travelling from Italy (70.6%), Germany (80.2%), France (64.5%), Norway (71.6%) and Sweden (56.6%). Better access to treatment than in country of origin was more often noted for UK patients (34.0%) than for other nationalities. Quality was an important factor for patients from most countries. The cross border phenomenon is now well entrenched. The data show that many patients travel to evade restrictive legislation in their own country, and that support from their home health providers is variable. There may be a need for professional societies to establish standards for cross border reproductive care.

When Problem Gambling is the Primary Reason for Seeking Addiction Treatment

An existing database was used to compare problem gamblers (N = 138) who presented for treatment of their gambling problem to two other groups: alcohol and/or drug addiction clients who also had a gambling problem (N = 280) or who did not have a gambling problem (N = 2178). Clients with gambling as their primary problem were more likely to be female; employed or retired; more highly educated; married, divorced, or widowed; without legal problems; and older than the other groups. They also had different patterns of recent mental health diagnoses and problematic substance use. The other problem gambling clients were more similar to the substance only clients. These findings indicate that those who present for treatment of problem gambling are a distinct subset of addiction clients who have gambling problems, and emphasize the importance of considering the reasons for seeking treatment, not just the presence of a gambling problem.

Motivations for seeking treatment for ED: the woman's perspective

There is increasing evidence that partners have a major role in treatment-seeking behavior for men with ED. This study investigated the motivations of 100 females for seeking medical treatment for their partner's ED. Semi-structured interviews focused on reasons for seeking treatment from the female's perspective. The themes that emerged from the data centered on the importance of sex in the relationship, with closeness and intimacy frequently being seen as more important than sex. The second major theme related to hopes that females had in relation to the medication, particularly in relation to increasing their partner's confidence and reducing his sexual frustration. Enhancement of the relationship as well as improving the female's own feelings of self-doubt and sexual frustration were also mentioned. The results of this study show the multi-faceted nature of the motivations that females express in terms of seeking help for their partner's ED.

Factors Associated with Inappropriate Utilisation of Emergency Department Services

This study was carried out to determine the associated factors and the reasons for inappropriate utilisation of Emergency Department (ED) services at Universiti Sains Malaysia Hospital. A case-control study was conducted with 170 cases from ED and 170 controls from the Outpatient Department (OPD). A self-administered questionnaire was designed and used to obtain sociodemographic data, knowledge on the functions of ED and OPD, health seeking attitude and behaviour, and reasons for seeking treatment at ED. The study found that gender, marital status, family size, shift work, perceived illness, and knowledge on the role and functions of ED and OPD were significant associated factors. The three most common reasons for inappropriate utilisation of ED were as follows: "due to severity of illness" (85%), "can't go to OPD during office hours" (42%), and "ED near my house" (27%).

A pioneering experience in Brazil: the creation of a support network for alcohol and drug dependent physicians. A preliminary report

The objectives of this study are to present the creation and operation of a support network to help physicians in Brazil, describe the socio-demographic profile, and investigate the prevalence of mental disorders and chemical dependence among physicians seeking treatment. Semi-structured interviews using ICD-10 criteria were conducted to obtain data regarding alcohol/drug dependence, and psychiatric comorbidity. Socio-demographic and occupational characteristics were obtained. 247 patients made contact and 192 attended the first evaluation visit. Of those, 158 were male, and most (55%) were married. The mean age was 42.4+/-11.1 years. The reasons for seeking treatment were: comorbidity between mental disorders and chemical dependence (67.7%); chemical dependence (20.8%); mental disorders (7.8%); and burnout (4.2%). The mean interval between the detection of the problem and seeking treatment was 7.5 years. Factors associated with the severity of the problem included unemployment (21.6%), difficulties of practicing professional activities (63.5%), problems with the Regional Council of Medicine (13%), psychiatric hospital admission (31.2%), and self-medication (71.8%). In our sample, 9.3% of the physicians had changed their area of specialization. A high prevalence of psychiatric disorders was found in this sample as well as psychosocial and professional problems. Treatment networks focusing on the physicians' mental health could catalyze cultural changes in treatment-seeking behavior, thereby improving early detection and treatment.

Potential work‐related exposures to bloodborne pathogens by industry and occupation in the United States Part II: A telephone interview study

The companion surveillance portion of this study [Chen and Jenkins, 2007] reported the frequency and rate of potential work-related exposures to bloodborne pathogens (BBP) treated in emergency departments (EDs) by industry and occupation, but it lacks details on the circumstances of the exposure and other relevant issues such as BBP safety training, use of personal protective equipment (PPE) or safety needles, or reasons for seeking treatment in a hospital ED. Telephone interviews were conducted with workers who had been treated in EDs for potential work-related exposures to BBP in 2000-2002. Respondents were drawn from the National Electronic Injury Surveillance System. Of the 593 interviews, 382 were from hospitals, 51 were from emergency medical service/firefighting (EMS/FF), 86 were from non-hospital healthcare settings (e.g., nursing homes, doctors' offices, home healthcare providers, etc.), 22 were from law enforcement (including police and correctional facilities), and 52 were from other non-healthcare settings (i.e., schools, hotels, and restaurants). Needlestick/sharps injuries were the primary source of exposure in hospitals and non-hospital healthcare settings. Skin and mucous membrane was the primary route of exposure in EMS/FF. Human bites accounted for a significant portion of the exposures in law enforcement and other non-healthcare settings. In general, workers from non-hospital settings were less likely to use PPE, to have BBP safety training, to be aware of the BBP standards and exposure treatment procedures, and to report or seek treatment for a work-related exposure compared to hospital workers. This study suggests that each industry group has unique needs that should be addressed.

Help-seeking Behaviors of Chinese Patients with Schizophrenia Admitted to a Psychiatric Hospital

To investigate the help-seeking behaviors and related factors of Chinese psychiatric inpatients with schizophrenia. Two hundred and two patients with schizophrenia (ICD-10) were enrolled in this study. A locally-developed, semi-structured questionnaire was used to collect data, including data on illness and help-seeking histories from patients, informants, and medical records. Among 202 inpatients, 120 patients (59.4%) had sought help from at least one type of non-psychiatric facility (NPF), and 82 patients (40.6%) went to a psychiatric hospital directly. Among the NPFs they contacted, 66 patients (32.7%) tried traditional Chinese medicine (TCM) from licensed practitioners (including acupuncturists), 64 (31.7%) chose general hospitals (including 9 who went to emergency departments), and 52 (25.7%) sought help from qigong (breathing exercise) masters or other folk healing methods. The reasons for seeking treatment from NPFs varied; the most common ones included feeling shameful or stigmatized about going to psychiatric hospitals, inaccessibility to or unavailability of psychiatric hospitals, and fear of being incarcerated or receiving electric shock treatment. A substantial proportion of psychiatric inpatients in China seek help from non-psychiatric facilities and/or folk healing methods. Feeling shameful or stigmatized, inaccessibility to and/or unavailability of psychiatric services are among the most common barriers to seeking psychiatric treatment. Patients who sought psychiatric help directly are likely to be female, with a chronic onset of illness, a mixed syndrome of positive and negative symptoms, or a better economic status.

Varicose veins: a qualitative study to explore expectations and reasons for seeking treatment.

Patients experience a wide range of symptoms from varicose veins and are seeking treatment from health care providers. However, there is little data on the relative effectiveness of the treatments available. Patients are therefore often confronted with a choice regarding treatment that they are ill-equipped to make. This lack of certainty and the resultant potential for variability in treatment decisions can mean that patients have expectations that are unrealistic or unfulfilled. The aim of our study was to explore patients' expectations and reasons for seeking treatment for varicose veins. Additional aims included the exploration of symptoms associated with varicose veins and their impact on quality of life. Qualitative study conducted in a large NHS Trust. A total of 16 patients, who had been referred to a specialist vascular service for the treatment of varicose veins, were recruited. Semi-structured interviews were used to explore the patients' reasons for seeking treatment. Framework analysis was used to analyse the data from the anonymized transcripts. Participants attributed a wide range of symptoms to their varicose veins, and were actively seeking treatment with the expectation that they would gain symptom relief. The symptoms attributed to their varicose veins had a significant negative impact on their quality of life and lifestyle. Improving the cosmetic appearance of their legs was seen as a secondary benefit. The perceived symptoms of varicose veins can impact on lifestyle and quality of life. Patients seek treatment with the expectation of treatment outcomes that are not supported by robust clinical evidence. Appropriate education and management of such expectations are an essential step in caring for this group of patients. Nurses are caring for patients with varicose veins in a range of clinical settings. When caring and providing information for this group of patients, nurses need to be aware of the impact of varicose vein symptoms and to understanding that patients may have unrealistic expectations or invalid reasons for seeking treatment.

Therapeutic Considerations in Work with Biracial Girls

Biracial girls face all the developmental challenges of growing up female and the additional challenge of forging an identity in a society that presses them to choose a monocultural existence and disavow part of their ethnic heritage. Existing literature raises several potential issues for biracial girls in terms of identity development, social and sexual relationships, and family. Therapist ethnic awareness, client physical appearance, reasons for seeking treatment, level of identity development, and environmental considerations are discussed. Therapists are encouraged to offer a sociopolitical perspective, promote biracial/bicultural identity development, assist biracial girls in connecting with a multicultural community, and work collaboratively with parents in fostering the positive development of biracial girls.