Responsibility For Own Health Research Articles

The Impact of Socioeconomic Status, Perceived Threat and Healthism on Vaccine Hesitancy

The ideology of healthism and low perceptions of the threat of vaccine-preventable diseases may explain the positive link between socioeconomic status (SES) and vaccine hesitancy in high-income countries. The present study aimed to examine the effect of three measures of SES (education, income and family economic status), the perceived threat of infectious diseases and two dimensions of healthism (personal responsibility for own health and distrust in healthcare institutions) on vaccine hesitancy, adjusting for sociodemographic variables. A cross-sectional quantitative study was performed in 2019. Non-probability sampling was employed by sending invitations to respondents over the age of 18 to participate in the study. The snowball technique was used, employing e-mails and digital social networks (Facebook, Twitter and Instagram). Data from 661 respondents were collected via 1 ka.si, an online survey tool. Multivariate regression analysis indicated that vaccine hesitancy was significantly more likely to be expressed by women (β = 0.09; p < 0.001), high-income respondents (β = 0.09; p < 0.01), those who have lower perceptions of the threat of vaccine-preventable diseases (β = 0.39; p < 0.001) and those scoring high on two healthism measures (expressing high perceived control of their own health (β = 0.18; p < 0.001) and high distrust in the Slovenian healthcare system and institutions (β = 0.37; p < 0.001)). The findings indicate that among the examined predictors, low perceived threat of vaccine-preventable diseases and low trust in the healthcare system are among the strongest predictors of vaccine hesitancy among the Slovenian public. Policymakers, physicians and other healthcare workers should be especially attentive to the public’s and patients’ perceptions of the risk of infectious diseases and distrust in medical institutions, including during doctor–patient communication and through public health campaigns and policies.

A Cross-Sectional Assessment of Self-Medication Among University Students of Lahore, Pakistan

<i>Background</i>: Symptoms or ailments that a person is aware of and chooses to treat on their own are referred to as self-medication. The idea of self-medication has been influenced by awareness of individual responsibility for own health and unnecessary professional care for mild illnesses. Self-medication is common practice around the globe. Gradually, it is becoming a form of self-care. Lot of research has been done in the area and the result revealed that the self-medication is more common among the literate people as compared to the illiterate. Trend is rather prominent among the young population who tend to have more knowledge of drugs and their use, have lower risk perception, therefore are more influenced by self-medication. <i>Objective</i>: A cross-sectional study was conducted to assess the knowledge about self-medication among engineering, arts & humanities students in Lahore during a period of 7 months (December 2018-June 2019).<i> Methodology</i>: A self-administered questionnaire was designed after the extensive review of previous research and was reviewed by an expert panel of professors & lecturers of clinical pharmacy of Punjab University College of pharmacy. Human ethics committee of Punjab University College of Pharmacy, University of the Punjab approved the study protocol. A total sample of 1000 students were calculated by sample size calculator. All statistical analysis was done by SPSS version 23. <i>Results:</i> A total of 1000 questionnaire were received with overall response rate of 63%. In this study, younger age, male, and unmarried students residing in hostels and those who have access to nearby pharmacy tended to self-medicate more than their peers with significant difference. About 43.4% of respondents followed their doctor's advice, while about 37.2% took their own advice or that of friends, family members, or the media. <i>Conclusion</i>: Self-medication misuse or abuse can be dangerous and endanger lives; if practiced impulsively, it may also be a health issue that requires education and attention from Pakistan's health care authorities. Future research is also required to determine how self-medication affects Lahore and Pakistan's non-medical students' health.

Сохранение здоровья детей: поиск путей решения актуальных проблем

Changed social reality, caused by the coronavirus pandemic (COVID-19), made attention to population's health, its risks, and defining factors relevant. Nowadays, an individual's personal responsibility for own health and coherence of various social institutions' activities in the formation of children's health are of particular importance. The article is devoted to an analysis of children's health and search for the ways of its improvement. The authors explore the issues of availability and quality of medical services, safeguard of children's health and discuss the barriers to inter-institutional cooperation in this field, as well as ways of overcoming them. To achieve these objectives, we used quantitative and qualitative sociological methods: a sociological survey of families with children aged 3-17 years, monitoring observation of cohorts of families with children, focus group studies of parents of children aged 3-17 years, an expert survey of specialists of the regional health system and members of government authorities. The authors reveal several issues: decline of children's health potential in growing;insufficient awareness of parents about the state, forms, and methods of preserving and strengthening children's health, discrepancy between parents' ideas about their own competence in this matter with reality;lack of narrow-profile specialists in children's medical institutions;absence of medical workers among fulltime staff of educational organizations;queues and complexity of making appointments with specialists;low availability of free and high cost of paid medical services;insufficient information interaction between medical, educational organizations and parents in the prevention of diseases;lack of parents' knowledge of full information about objectives of professional examinations and insufficient awareness of the importance of further actions to restore and strengthen health of children. Based on the analysis, we stated the areas of solving these problems. They may include the development and implementation of specific management tools to preserve children's health potential.

A STATISTICAL ANALYSIS OF WOMEN’S REPRODUCTIVE HEALTH CHARACTERISTICS AFTER INEFFECTIVE REATTEMPTS OF USING ART

The aim: To carry out a statistical analysis of physical and reproductive health characteristics in women after ineffective reattempts of using assisted reproductive technologies and identify significant medical and social factors contributing to the development of chronic endometritis. Materials and methods: We carried out a statistical analysis involving 177 outpatient medical records: group 1 includes 127 women aged under 45 with two or more ineffective attempts of in vitro fertilization; group 2 comprised 50 healthy women without reproductive disorders. The complete physical exam included past history, clinical and gynecologic examination, lab techniques and medical imaging according to outpatient medical records obtained during the follow-up care in Isida-IVF Medical Center LLC. Chronic endometritis was recognized by means of histologic examination of endometrium, with the samples obtained by an endometrial pipelle biopsy on day 4-9 of the menstrual cycle. Results: The prevalence of pelvic inflammatory disease in patients of group 1 comprised 47.2%, endometritis - 41.7%; p1.2 <0.01. The prevalence of acute endometritis among patients of group 1 comprised 6.3%; p1.2 >0.05 and was associated with an infection after abortion. In group 1, sexually transmitted infections were reported in 67.7% of patients, p1.2> 0.05, bacterial vaginosis was registered 1.5 times more often - 28.4%; p1.2 <0.05. In group 1, single induced abortion was reported in 15.0%, while 2 times it took place in 15.7% (p1.2 <0.05). Laparoscopies were previously performed in 59.8% of women, laparotomies - in 62.2%, while in 25.4% of women these interventions were reperformed. Unilateral salpingectomy, due to ectopic pregnancy, was performed in 25.4% of women, bilateral - in 12.7%. Fallopian tube removal, due to sactosalpinx, was performed in 25.4% of women, unilateral salpingectomy took place in 3.9% of cases. The most significant risk factors of chronic endometritis in groups studied are acute postabortal endometritis, RR (relative risk) = 1.439, p = 0.029 and postoperative peritonitis provoked by the complications of appendectomy, RR = 1.430, p = 0.084. We detected none of significant effects of pelvic inflammatory disease on the development of chronic endometritis (RR = 45.132, Confidence interval (CI) (6.151-331.167), p = 0.001). The analysis of reproductive failures, as a risk factor of chronic endometritis in women of group 1, showed a significant relative risk: with the past history of premature birth, RR = 1.44, p = 0.039, in case of reattempts of induced abortions, RR = 1.5, p<0.001, Spontaneous miscarriage RR = 1.572, p = 0.001. A higher relative risk of developing chronic endometritis was observed during pregnancy - RR = 1.597, p = 0.001. Conclusions: Statistical analysis of women's reproductive health after ineffective reattempts of using ART revealed that the high rate of fetal interventions, low rate of alternative and safe abortion methods are registered in these women, as well as the nonavailability of any system of health measures after reproductive failures. A significant increase in miscarriage at early stages takes place, as well as the absence of a tendency for preterm labor to decrease in the rate. Maintaining women's reproductive health is a considerable medical and social issue, whose resolving depends on joint efforts of governmental and public entities, healthcare agencies and the population responsibility for own health. Designing and adopting the program of preconception care and planning for pregnancy in women after ineffective reattempts of using ART, with chronic endometritis as a primary disease, should be the top priority area of a health care system.

Patients’ expectations for and experiences with primary healthcare services received from a patient centered medical home

ObjectiveExpectations for and experiences with healthcare services are summarized for 1143 patients receiving care in a statewide demonstration of Patient Centered Medical Homes (PCMH). MethodsPatients were recruited from 91 primary care clinics for semi-structured interviews to determine what patients expect, what they plan to do and how they intend to execute their plans in partnership with their healthcare team. ResultsThe majority (78%) of patients defined the patient-team partnership as a collaborative and problem-solving effort. Overall, 68% defined responsibility for own health as a personal responsibility; 55% defined listening to patient’s concerns and answering questions as a responsibility of their healthcare team. Diet and exercise came up most frequently whether as a personal responsibility, issues for receiving additional help from their clinic, or plans for personal change. ConclusionPatients’ preferred a collaborative, problem-solving healthcare team partnership but also had boundaries for what additional services they wanted from this team.Practice Implications: Patients’ expectations for a collaborative partnership, acceptance of personal responsibility and interest in diet and exercise expands opportunities for patient education and teamwork. Clinics’ engagement with broader resources would be needed to address patients’ many and varied challenges to taking care of their health.

The Sense of Responsibility for own Health and the Influence of the Disease on Daily Functioning Among Patients with Multiple Sclerosis

Introduction. MS is characterized by a large variety of symptoms, which negatively affects the functioning and quality of life of patients.Aim. The purpose of the work is determination of the impact of Multiple Sclerosis on the daily functioning of patients and assessment of the sense of responsibility for one’s own health among patients with Multiple Sclerosis.Material and Methods. The study included 97 patients suffering from Multiple Sclerosis, treated at the Department of Neurology, University Hospital in Białystok. Study group consisted of 73 women and 24 men. The research has been conducted using the diagnostic survey method with following research tools: Activities of Daily Living scale; Instrumental Activities of Daily Living scale; Multidimensional Health Locus of Control and a self-constructed questionnaire.Results. The average age of the respondents was 52 (±10.36) and was comparable for women and men — 52.33 (±10.97) years and 51.79 (±8.42) years, respectively. The duration of the disease was on average 8 years (±3.87). Among the respondents, from the beginning of the disease, on average 5.02 exacerbations of MS (±3.08) have been observed. The most significant problem for MS patients was sphincter control (45.36%), independent bath (34.02%) and use of the toilet (31.96%). According to Lawton’s scale, patients with MS had most difficulties going out for shopping and getting outside walking distance. With the duration of the disease, the internal location of health control decreased significantly.Conclusions. As a result of increasing restrictions on the independent functioning of patients with Multiple Sclerosis, the sense of control over their own health is located in external factors such as chance and the influence of others. (JNNN 2019;8(3):102–111)

"All boys and men can play football": a qualitative investigation of recreational football in prostate cancer patients.

Evidence is accumulating that exercise-based rehabilitation improves physical capacity and quality of life in cancer survivors. However, recruitment and persistence of male cancer patients in rehabilitation and physical activity are low and novel health promotion strategies are warranted. The purpose of this study was to gain an understanding of the meaning of recreational football as a team and interaction-oriented health-promoting activity in men with prostate cancer (n = 26). Qualitative data were collected through six focus group interviews (n = 4-6) and 20 h of participant observations. The two data sets were analyzed using framework analysis. The analysis produced 11 subthemes that were structured into three overarching themes: (a) motivational drivers; (b) united in sport; and (c) confirmation of own capacity. The findings indicated that participants regarded football as a welcome opportunity to regain control and acquire a sense of responsibility for own health without assuming the patient role, and football training legitimized and promoted mutual caring behavior in a male-oriented context. In conclusion, the study suggests that football, due to its cultural representation of masculine ideals, may be a potent and unique strategy for increasing recruitment and adherence to physical activity in prostate cancer patients.

Patients’ experiences of care quality and satisfaction during hospital stay: a qualitative study

Rationale, aim and objectives: Patients experiencing high care quality and satisfied patients are more likely to follow treatments. Patient satisfaction is an important contributor to physical and mental health-related quality of life. Research emphasises the need to further study satisfaction from the patients’ perspective. The aim was to describe patients’ experiences of care quality and the relation to their satisfaction during hospital stay. Methods: A qualitative descriptive design was used. Interviews were conducted with 22 patients discharged from hospital. Data was analysed by conventional content analysis. Results: Four categories and seven subcategories describing patients’ experiences of care quality and the relation to their satisfaction emerged. Desire to regain health comprised waiting for treatment, being cured, having hopes of being cured and described the treatment and health outcome of hospitalisation. Need to be met in a professional way as a unique person comprised receiving personalized knowledge , receiving healthcare by competent healthcare personnel and described the way patients need to be met by healthcare personnel. Need to be involved comprised taking responsibility for own health, leaving responsibility for own health and concerned the patients’ way of handling hospitalisation. Nee d to have balance between privacy and companionship concerned the relationship to fellow patients. Conclusions: Health condition is of great importance to patients’ experiences of quality of care and their satisfaction in relation to hospital stay. The healthcare personnel need to be aware that seriously ill patients may never be completely satisfied. Furthermore, healthcare personnel must do their utmost to provide the patients with person-centered care. Hospital managers must consider the design of wards with respect to such matters as multiple-bed versus single-bed rooms and heads of nursing must carefully plan each patient’s accommodation.

The characteristics of the pediatric model for counteracting obesity in Serbia

Basic data on the establishment, features and results of the health care system for children and adolescents in the Republic of Serbia during the period 1950-1990 are given in the introductory remarks. Enormous pressure for the change of the health sector ownership and the profile of physicians in the primary pediatric care in the last decade of 20th century and at the beginning of 21st century is also emphasized. The destructive consequences of the sanctions of international community (1992-1995), NATO aggression (1999) and the change of the political system in Serbia (2000) caused the huge loss of gross domestic product, increase of the unemployment and poverty rates, and the decrease of the health expenditure rate to unsustainable levels (200-300 USD per capita). In spite of all misfortunes, Pediatric Association of Serbia, in response to the global obesity epidemic, offered in 2007 to the Ministry of health and the National Institute for health insurance the Project 'The prevention and treatment of obesity in children and adolescents in Serbia', as the pediatric chapter for future National strategy for counteracting obesity. The Project, ie the pediatric model for counteracting obesity is funded on the features of the health care system for children and adolescents in our country. The solidarity of the society and the continuous education of health care workers, adolescents and their parents about the significance of obesity epidemic are, in our conviction, key factors for the strengthening of adolescent's conscience on individual responsibility for own health as the prerequisite for successful control of obesity epidemic in adolescents.

Some interpersonal and attitudinal factors characterizing patients satisfied with medical care.

This research investigated the extent to which interpersonal and attitudinal factors affect the doctor-patient relationship. A questionnaire survey of people living in northeastern Kansas who had experience with medical care was conducted. Dependent measures were over-all patient satisfaction, patient's attitude toward death of self or others, causality orientation, attitude toward health and disease, and perception of the doctor-patient relationship. The majority of test subjects (92%) reported satisfaction with their medical care. A significant correlation between fear of death of significant others and scores on causality scales reflects feelings of not being in control of one's life. Other associations indicate that people who do not feel in control of their lives depend on traditional and folk remedies. Scores showing low fear of own death correlated significantly with the rated greater sense of responsibility for own health and treatment. Patients who rated themselves as more needy were unsatisfied with their care and those whose doctors called them by first name tended to be more content. Even in populations satisfied with their medical care, we suggest that the quality of care could be improved by attention to interpersonal and attitudinal factors.