Search results

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

In this paper, a theoretical and applied understanding is brought to the study of acute myocardial infarction [AMI] care‐seeking behavior. The time between the onset of an AMI and the initiation of definitive medical care is presently the single most important factor impeding reduced mortality and improved morbidity from thrombolytic therapy. It is suggested that the acknowledged, yet relatively neglected, area of emotional response is a key element in understanding why individuals may delay seeking definitive health care services following the onset of AMI symptoms. Emotionally significant dimensions of the care‐seeking process and a model for intervention to reduce morbidity and mortality are presented.

South Sudanese people form the largest number of resettled refugees in Australia between 2003 and 2004. This study aims to explore how this community understands and responds to health and illness. No study has specifically examined the concept of health and illness in the broader socio-cultural context of the South Sudanese people in Australia.

The design was a qualitative study using interviews and focus group discussions with 33 South Sudanese people in Adelaide, South Australia. Participants were asked to reflect on their understanding of health and illness and influences on their access and use of health and other services. Data were electronically audio-recorded, transcribed verbatim and analysed thematically.

Three main themes emerged from the analysis demonstrating complex and multifaceted views on health and illness. Participants described health as both a lack of disease and wider issues involving social belonging and participation, cultural well-being, living conditions and harmony in the society. They revealed that illnesses are predetermined by God or caused by a curse, breaking a cultural taboo, disharmony with the environment, community and ancestral spirits. Participants deeply tied their beliefs about illness causation and treatment to their historical, social and cultural lived realities, shaping their responses and health-care-seeking decisions.

The current study revealed a complex understanding of health and health-care-seeking practices amongst South Sudanese Australians. The multifaceted views of health and health-care-seeking practices underscore the importance of person-centred care for culturally and linguistically diverse people.

The objectives of the current interim report are to measure the extent of the access to care problem, identify and compare the types of patient- and system-based barriers experienced by Vietnam veterans at risk for suicide when seeking care for physical, psychiatric, and substance abuse conditions, analyze patient-perceived quality of care for individuals who obtained access to care, and identify how the care-seeking experience effected future care seeking. This study is based on a longitudinal sample of 494 Vietnam veterans discharged from military service in September 1971 and subsequently identified as at risk for suicide (306 low risk; 188 high risk). Seventy-one percent (350) of 494 participants completed an extensive qualitative and quantitative interview covering, among other topics, physical conditions, psychiatric conditions, substance use, barriers to care, facilitators of care, and quality of care. Barriers, satisfaction, and effect of the experience were compared by type of condition and suicidal risk category using χ2 analysis and Fisher's as appropriate. The analysis is based on 257 interviews (73 percent) with qualitative data transcribed thus far. Results: Of the 195 patients with self-reported health conditions, 76 (39.0 percent) and 45 (23.1 percent) expressed system-based barriers to care, respectively. The group at higher risk of suicide was significantly more likely (p<0.01) to report patient-based barriers to care and system-based barriers to care (p<0.05), and more likely (p<0.05) to experience negative effects of the care-seeking experience. Both self-perceived and system-based barriers to care pose obstacles for patients at high risk of suicide. Targeted interventions are required to reach out to these patients to address needs for care currently unmet by the health care system and to reduce negative effects of the health care experience.

Around three million infants die within the first four weeks of life each year – nearly all (98%) of these deaths occur in developing countries. Approximately one million newborns die each year in India. Therefore, this study aims to determine the patterns of reported neonatal morbidity and care-seeking behavior and identify factors associated with it.

A cross-sectional study was conducted during November 2016. A systematic random sampling technique was used to select the sample. Statistical techniques like Binary Logistic regression and chi-square test were used.

The results of the study showed that around 31% mothers of neonates reported that their neonates suffered from some kind of morbidity. Fever, jaundice, cough and cold, the low birth-weight and difficulty in breathing were the most common dangers signs reported. Birth order and mother’s knowledge of neonatal danger signs were found to be significantly associated with reporting of neonatal morbidity. In all 95% of the mothers sought care for their newborns. Among those who had problems, 59% consulted private hospitals/clinics, 30% visited District Hospital/Taluka Hospital or higher facilities and another 9% to Primary Health Centers/Community Health Centers. Further, findings show that nearly half of the neonates taken to government facilities have got free treatment, whereas an average cost of 7,156 INR were recorded for treatment, 935 INR for outpatient department and 13,774 INR for inpatient department cases.

There is an urgent need to implement intervention modalities that focus on increasing the level of parental education and access to treatment, and advocating the message regarding newborn danger signs during pregnancy is pinpointed.

In 2007, Nigeria commenced a nationwide behavioural change communication (BCC) intervention to increase uptake of tuberculosis (TB) care services. The purpose of this paper is to evaluate the effect of TB BCC intervention on knowledge and perception of TB in Enugu state, southeast Nigeria.

This is a cross-sectional study carried out in December 2009 in which a total of 1,200 respondents (620 males and 580 females) from six local government areas (three urban and three rural), selected by multi-stage sampling technique were interviewed using a semi-structured questionnaire.

The survey showed that most of the respondents had access to radio and about half to television. Access to media was significantly higher in urban areas than rural areas. Radio and community were the commonest sources of information of TB. The majority of the respondents were aware of that there was a message, however, ability to recall the content of the message varied. Significant association was observed between knowledge of the health education message and knowledge of TB transmission, that TB is curable and of appropriate care-seeking behaviour. Access to this media health education intervention was determined by age, gender, educational status, literacy, religion and access to media.

The study showed that TB BCC is associated with high-level awareness of TB disease and appropriate care-seeking behaviour. Socio-demographic characteristics and locality were found to influence access to mass media communication. Therefore, consideration should be given to the appropriateness of medium of communication in the design of TB BCC. However, there is need to combine it with other strategies to reach the disadvantaged population.

This study is the first population-based survey to ascertain access to TB-related BCC intervention and its effect on knowledge and care-seeking behaviour of this study population.

Objective – Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the aim of encouraging greater use of professional care at childbirth. It provided cash to women giving birth in a public health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We aimed to assess the impact of the programme on neonatal mortality and health care seeking behaviour at childbirth in one district of Nepal.

Methods – Impacts were identified using an interrupted time series approach, applied to household data. We estimated a model linking the level of each outcome at a point in time to the start of the programme, demographic controls, a vector of time variables and community-level fixed effects.

Findings – The recipients of the cash transfer in the programme's first two years were disproportionately wealthier households, reflecting existing inequality in the use of government maternity services. In places with women's groups – where information about the policy was widely disseminated – the SDIP substantially increased skilled birth attendance, but failed to impact on either neonatal mortality or the caesarean section rate. In places with no women's groups, the SDIP had no impact on utilisation outcomes or neonatal mortality.

Implications for policy – The lack of any impact on neonatal mortality suggests that greater increases in utilisation or better quality of care are needed to improve health outcomes. The SDIP changed health care seeking behaviour only in those areas with women's groups highlighting the importance of effective communication of the policy to the wider public.

A plethora of studies have documented evidence on morbidity patterns and treatment-seeking behaviour among older persons in India. However, so far no attempt has been made to understand differences in the morbidity prevalence rates and utilization of health care services among older adults between religion groups in India. The purpose of this paper is to make an effort in this direction.

Multivariate logistic regression models were fitted to examine the association between socio-demographic conditions and morbidity prevalence and health care-seeking behaviours among the two religion groups: Hindu and Muslim. Data from the 60th round of the National Sample Survey in 2004 were used.

This study provided interesting evidence that, overall, the morbidity prevalence rate was higher among Muslim older persons than their Hindu counterparts by seven percentage points and Hindu scheduled caste (SC) and scheduled tribe (ST) counterpart population (compared to SCs eight percentage points, and STs 20 percentage points); income had no association with the burden of disease among Muslim older population – an older person belonging to the first income quintile was equally likely to report ill-health as an older person of the fifth income quintile. However, despite the low socio-economic status, Muslim older persons were more likely to seek treatment for ill-health compared to Hindu older persons but spent less money for treatment. Also, loss of household income due to sickness was greater among Muslim compared to Hindu older adults.

The findings of this study are important to support the policy makers and health care providers in identifying individuals “at risk” and could be integrated into the current programs of social, economic and health security for the older persons.

The purpose of this paper is to invite readers to consider a model of compassionate leadership to contribute to the prevention of abuse in collective care settings.

This paper examines a model of leadership based on theories of attachment and parenting and draws on evidence from practice. The framework, which we call Total Attachment, originated in a foster care organisation which was designed around the approach as a way of supporting carers to care for children who were, largely deemed as unfosterable. It explores literature examining workplace culture and the potential for detachment as workers try to survive their employment. It then offers an approach which has been adopted by a Safeguarding Adults partnership to implement a prevention framework into collective care settings for older people. This has placed Total Attachment at the heart of its promotion of compassionate care giving.

Consultation from the launch of the prevention framework indicated that Total Attachment had a resonance with providers and was readily understood and its value, tangible as a whole systems approach to enabling compassionate caring. The efficacy of the model in supporting workers to be resilient and effective is quantified by data from the foster organisation.

Total Attachment draws on transference of practice learning and experience across life span services. Attachment theory is largely considered a framework informing child care, however, this model recognises the attachment story across the life span.

This model shows how compassionate care can be led rather than simply taught; how carers and workers can be shown a way of working that connects deeply with their own need for care giving and care seeking.

This paper shares creative, innovative practice that can be implemented in services across the life span. It offers a model for leading compassionate care in a whole systems approach with an evidence base of its efficacy.

Addresses the important question of the optimal share and distribution of primary and hospital care, stating that the end‐user consensus is essential. On a classical medical ground with integrated medical services the care seeking patterns and preferences were investigated in a representative sample of the, hence reasonably unbiased, native population. In a small Cretan township hospital combining secondary and primary care, a questionnaire of habits, perceptions and expectations of health services delivery and provision was distributed to a consecutive visitor sample. Overall, primary care was well and realistically appreciated. In six of the 12 conditions, mostly with fever and/or pain, general practitioners were clearly preferred while in three, as a rule organ‐associated, specialists were the first choice. The consumer‐oriented survey brings additional support to the vital role of primary care in the ongoing health systems development.