health-seeking behaviour

寻求健康的行为
  • 文章类型: Journal Article
    背景:城市贫困妇女面临性别不平等和城市贫困的双重挑战,这使得他们更有可能出现健康问题并影响他们寻求健康的行为。这项研究旨在确定吉隆坡城市贫困妇女患病期间寻求健康行为的患病率和寻求护理的预测因素,马来西亚。
    方法:这项横断面研究是在2023年4月至5月随机选择的340名女性居民中进行的。使用经过验证和可靠的自我管理问卷收集数据,并使用SPSS28.0版软件进行分析。这项研究的因变量是生病期间的寻求健康行为,而自变量是社会人口统计学特征,社会经济特征,医疗条件,妇女在决策中的自主权,社会支持,感知到的耻辱,以及对健康的态度。多元逻辑回归用于确定患病期间寻求护理的预测因素。
    结果:研究反应率为100%,72.4%的人在生病时寻求护理。非马来人(AOR=4.33,95%CI:1.847,10.161),拥有医疗保险(AOR=2.60,95%CI:1.466,4.612),将他们的健康状况评为良好(AOR=1.87,95%CI:1.119,3.118),并且已存在慢性疾病(AOR=1.92,95%CI:1.130,3.271)被确定为患病期间寻求治疗的预测因子.
    结论:本研究表明,参与者在患病期间寻求健康的行为是适当的。健康促进和教育,专注于教育和提高人们对寻求及时医疗保健的重要性的认识,对于改善城市贫困妇女寻求健康的行为至关重要。需要与相关利益攸关方合作,制定全面战略,改善这些妇女获得医疗保健设施的机会。
    BACKGROUND: Urban poor women face dual challenges regarding gender inequalities and urban poverty, which make them more likely to have health problems and affect their health-seeking behaviour. This study aimed to determine the prevalence of health-seeking behaviour during times of illness and predictors of sought care among urban poor women in Kuala Lumpur, Malaysia.
    METHODS: This cross-sectional study was performed among 340 randomly selected women residents from April to May 2023. Data was collected using a validated and reliable self-administered questionnaire and analysed using SPSS version 28.0 software. The dependent variable in this study was health-seeking behaviour during times of illness, while the independent variables were sociodemographic characteristics, socioeconomic characteristics, medical conditions, women\'s autonomy in decision-making, social support, perceived stigma, and attitude towards health. Multiple logistic regression was used to identify the predictors of sought care during times of illness.
    RESULTS: Study response rate was 100%, where 72.4% sought care during times of illness. Being non-Malay (AOR = 4.33, 95% CI: 1.847, 10.161), having healthcare coverage (AOR = 2.60, 95% CI: 1.466, 4.612), rating their health as good (AOR = 1.87, 95% CI: 1.119, 3.118), and having pre-existing chronic diseases (AOR = 1.92, 95% CI: 1.130, 3.271) were identified as predictors of sought care during times of illness.
    CONCLUSIONS: The present study showed that health-seeking behaviour during times of illness among the participants was appropriate. Health promotion and education, with a focus on educating and raising awareness about the importance of seeking timely healthcare, are crucial to improving health-seeking behaviour among urban poor women. Collaboration with relevant stakeholders is needed to develop comprehensive strategies to improve access to healthcare facilities for these women.
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  • 文章类型: Journal Article
    背景:呼吸系统疾病,包括一系列的疾病,是儿童死亡率和发病率的主要原因,肺炎尤其严重,占儿童死亡率的16%。为了确保及时参与医疗保健服务,必须通过信息灌输意识,教育,和针对五岁以下儿童的母亲的沟通(IEC)倡议。这项试点研究的主要目的是评估以社区为基础的干预措施对寻求健康的行为的可行性,知识,并实施有关儿童肺炎管理和预防的措施。
    方法:试点研究反映了两个村庄的主要研究程序,Bhuvanahalli和Gavanahalli,每个随机分配为实验组或对照组。我们选择了12名母亲,她们的孩子年龄在5岁以下,患有社区获得性肺炎,采用简单的随机技术,每组有六名母亲。这些母亲使用结构化问卷进行了访谈,重点是寻求健康的行为,知识,以及与肺炎的管理和预防有关的做法。实验组的母亲接受了基于社区的干预,特别是一个专注于寻求健康行为的教育系统,知识,并实施有关儿童肺炎管理和预防的措施,而对照组的人继续他们的常规做法。我们在第2天收集了两组母亲的测试后数据,第四,干预的第6个月。数据分析使用IBMSPSSStatisticsforWindows进行,版本28(2021年发布;IBMCorp.,Armonk,纽约)软件。Mann-Whitney检验和Kruskal-Wallis分析表明,寻求健康的行为发生了显着且具有统计学意义的变化,知识,通过实施社区教育干预,实验组在儿童肺炎的管理和预防方面的实践(P<0.05)。
    结论:基于社区的干预措施对于预防儿童死亡率和发病率至关重要。试点研究的结果肯定了其可行性,为进一步调查和实施奠定了坚实的基础。
    BACKGROUND: Respiratory ailments, encompassing a spectrum of disorders, are a leading cause of mortality and morbidity in children, with pneumonia being particularly significant, accounting for 16% of child mortality. To ensure timely engagement with healthcare services, it is imperative to instill awareness through Information, Education, and Communication (IEC) initiatives targeting mothers of children under five. The primary objective of this pilot study is to assess the feasibility of a community-based intervention on health-seeking behaviour, knowledge, and practice measures concerning the management and prevention of pneumonia in children.
    METHODS: The pilot study mirrored the main study\'s procedures in two villages, Bhuvanahalli and Gavanahalli, each randomly assigned as either an experimental or a control group. We selected 12 mothers with children under the age of five who had community-acquired pneumonia, employing a straightforward random technique, with six mothers from each group. These mothers were interviewed using a structured questionnaire focusing on health-seeking behaviour, knowledge, and practices related to the management and prevention of pneumonia. Mothers in the experimental group received a community-based intervention, specifically an educational set focusing on health-seeking behaviour, knowledge, and practice measures concerning the management and prevention of pneumonia in children, while those in the control group continued with their routine practices. We collected post-test data from the mothers in both groups at the 2nd, 4th, and 6th months of the intervention. The data analysis was conducted using the IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York) software. The Mann-Whitney test and Kruskal-Wallis analyses indicated a notable and statistically significant shift in health-seeking behaviour, knowledge, and practices pertaining to the management and prevention of pneumonia in children as a result of the community-based educational intervention implemented in the experimental group (P<0.05).
    CONCLUSIONS: Community-based intervention is crucial to preventing mortality and morbidity in children. The findings of the pilot study affirm its feasibility and lay a strong foundation for further investigation and implementation.
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  • 文章类型: Journal Article
    适当的寻求健康的行为有助于降低儿童死亡率和发病率。有关印度城市贫民窟5岁以下儿童看护人的死亡率和寻求健康行为的社会因素的信息在文献中很少。
    我们估计了金奈市城市贫民窟中5岁儿童的发病率及其决定因素的寻求健康行为的患病率,印度。
    在居住在金奈贫民窟的5岁以下儿童的主要照顾者中使用混合方法设计进行了一项横断面研究,印度。采用两阶段整群抽样,选取了40个贫民窟。总共采访了233名主要护理人员。在主要护理人员中进行了9次焦点小组讨论和18次深入访谈。估计了不适当的寻求健康行为的患病率,并通过多元二元逻辑回归分析确定决定因素。对定性数据进行了专题分析。
    我们采访了233名主要护理人员。钦奈城市贫民窟中五岁以下儿童不适当寻求健康行为的加权患病率为53.9%(95%CI:46.9-60.8)。与受过以下教育的人相比,受过中学以上教育的主要护理人员更有可能(AOR为2.3,95%CI:1.3-4.1)遵循不适当的寻求健康的行为。同样,未知晓幼儿喂养习惯(AOR为3.6,95%CI:1.9~6.5)和早期寻求护理和健康习惯(AOR为2.5,95%CI:1.3~4.9)的护理人员与知晓的护理人员相比,更有可能发生不适当的寻求健康行为,我们发现疾病症状会影响寻求健康的行为,早期疾病检测可预防严重疾病.
    在钦奈城市贫民窟的5岁以下儿童中,寻求健康的行为被发现是次优的。我们建议决策者在城市卫生计划中改善对常见儿童疾病的早期护理的干预措施。
    UNASSIGNED: Appropriate health-seeking behaviour could help in reducing child mortality and morbidity. Information on social factors of mortality and health-seeking behaviours of caregivers of under-5 children from slums of Indian cities is minimal in literature.
    UNASSIGNED: We estimated the prevalence of health-seeking behaviour for morbidity ofunder-5 children and its determinants in urban slums in Chennai city, India.
    UNASSIGNED: A cross-sectional study was conducted using a mixed-method design among primary caregivers of under-5 children living in Chennai slums, India. Two-stage cluster sampling was adopted to select 40 slums. A total of 233 primary caregivers were interviewed. Nine focus group discussions and 18 in-depth interviews were conducted among the primary caregivers. Prevalence of inappropriate health-seeking behaviour was estimated, and determinants were identified by multivariate binary logistic regression analysis. Thematic analysis was done on qualitative data.
    UNASSIGNED: We interviewed 233 primary caregivers. The weighted prevalence of inappropriate health-seeking behaviour for under-five children in urban slums of Chennai was 53.9% (95% CI: 46.9 - 60.8). Primary caregivers educated above secondary school were more likely (AOR of 2.3, 95% CI: 1.3-4.1) to follow inappropriate health-seeking behaviour compared to those educated below. Similarly, caregivers who were unaware of young child feeding practices (AOR of 3.6, 95% CI: 1.9-6.5) and early care-seeking and health practices (AOR of 2.5, 95% CI: 1.3-4.9) were more likely to engage in inappropriate health-seeking behaviour compared to those who were aware and we found that illness symptoms influenced health-seeking behaviour and that early disease detection might prevent severe illness.
    UNASSIGNED: Health-seeking behaviour was found to be suboptimal among under-5 children in Chennai\'s urban slums. We suggest policymakers improve interventions on early care-seeking of common childhood illnesses in the urban health programme.
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    文章类型: Congress
    主观幸福感(SWB)和寻求健康行为(HSB)是衡量多症老年人健康状况的重要医疗渠道,特别是在资源贫乏,社会医疗和卫生基础设施有限的环境中。
    本研究的目的是确定尼日利亚东南部农村初级保健环境中多症老年人SWB和HSB的概况和预测因子。
    2022年1月至12月在尼日利亚东南部对214名患有多发病率的老年人进行了横断面研究。数据收集是使用结构化的,预测试和面试官指导问卷。使用单项自评健康状况问卷确定主观幸福感。使用初级保健多症评估问卷(MAQ-PC)确定多症。
    研究参与者的年龄为60-99岁(x=68±4.5岁)。有123名(57.5%)女性。93(43.5%)的研究参与者具有良好的SWB,而86(40.2%)具有适当的HSB。最常见的多发性疾病是心血管疾病,肌肉骨骼和胃肠系统。SWB差的独立预测因素是高龄(ORs=3.101;95CI(1.526-6.019);P=0.024),低教育(ORs=4.056;95CI(2.512-8.509);P=.025)和非家庭家庭结构(ORs=2.225;95CI(1.078-6.192);P=.001)。男性预测不适当的HSB(ORs=2.428;95CI(1.107-6.379);P=0.039),低教育程度(ORs=3.007;95CI(1.387-7.001);P=.013)和无中等职业的退休人员(ORs=4.761;95CI(1.351-8.072);P=.001)。
    该研究显示了研究参与者中的SWB和HSB。SWB差的独立预测因素是高龄,低教育和非家庭家庭结构。男性预测HSB不合适,教育水平低,退休人员没有中等职业。在与患有多种疾病的老年人进行临床咨询时,应探索主观幸福感和HSB,特别是在非传染性和传染性疾病双重打击的次区域。
    UNASSIGNED: Subjective well-being(SWB) and health-seeking behaviour(HSB) are important medical channels to gauge the health status of older persons with multimorbidity particularly in resource-poor environment with limited socio-medical and health infrastructure.
    UNASSIGNED: The aim of the study was to determine the profiles and predictors of SWB and HSB among older persons with multimorbidity in a rural primary care environment in South-Eastern Nigeria.
    UNASSIGNED: A cross-sectional study was conducted on 214 older persons with multimorbidity from January to December 2022 in South-Eastern Nigeria. Data collection was done using structured, pretested and interviewer guided questionnaire. Subjective well-being was determine using single-item self-rated health status questionnaire. Multimorbidity was determine using Multimorbidity Assessment Questionnaire for Primary Care(MAQ-PC).
    UNASSIGNED: The ages of study participants were 60-99 years(x=68±4.5 years). There were 123(57.5%) females. Ninety-three (43.5%) of the study participants had good SWB while 86(40.2%) had appropriate HSB. The most common multimorbidities were aggregate disorders of cardiovascular, musculoskeletal and gastrointestinal systems. The independent predictors of poor SWB were advanced old age(ORs=3.101; 95%CI(1.526-6.019); P=.024), low education(ORs=4.056; 95%CI(2.512-8.509); P=.025) and non-household family structure(ORs=2.225; 95%CI(1.078-6.192); P= .001). Inappropriate HSB were predicted by males(ORs=2.428; 95%CI(1.107-6.379); P=.039), low education(ORs=3.007; 95%CI(1.387-7.001); P=.013) and retirees with no secondary occupation (ORs=4.761;95%CI(1.351- 8.072); P= .001).
    UNASSIGNED: The study has shown the SWB and HSB among the study participants. The independent predictors of poor SWB were advanced old age, low education and non-household family structure. Inappropriate HSB werepredicted by males, low education and retirees with no secondary occupation. Subjective well-being and HSB should be explored during clinical consultations with older persons with multimorbidity particularly in the sub-region with double whammy of non-communicable and communicable diseases.
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  • 文章类型: Journal Article
    要评估月经特征,感知,和女性寻求健康的行为。
    我们在2021年2月至2021年10月期间对394名女性进行了这项横断面研究。根据女性的自我认知,月经特征分为两组,包括\'正常\'和\'异常\'。数据是使用个人信息表格收集的,月经周期特征评估表,和寻求健康行为量表。
    在所有女性中,49.7%的人认为他们的月经特征为“正常”,50.3%的人认为他们是“异常”。月经特征对正常组57.6%的女性和异常组68.7%的女性的日常生活产生负面影响。在线寻求健康的行为是寻求补救的最常见行为;然而,专业的寻求健康的行为是不够的。在认为自己的月经特征为“正常”的女性中,月经出血过多,极度痛苦,对日常生活的不利影响增加了寻求健康的行为。在认为自己的月经特征为“异常”的女性中,不规则循环,频繁出血,低水平的出血,使用太多的垫,极度痛苦,对日常生活的不利影响增加了寻求健康的行为。
    这项研究的参与者对月经异常特征表现出不足的寻求健康的行为。妇女应该由卫生专业人员引导到可靠的在线资源寻求帮助,应该鼓励他们表现出专业的寻求健康的行为。
    女性对月经特征的认识和认识不足。这项研究的结果表明,许多可能影响女性后期生活的妇科症状可能会被无意中忽略。
    UNASSIGNED: To evaluate menstruation characteristics, perceptions, and health-seeking behaviours in women.
    UNASSIGNED: We conducted this cross-sectional study with 394 women between February 2021 and October 2021. According to the self-perception of women, menstruation characteristics were divided into two groups, including \'normal\' and \'abnormal\'. The data were collected using the Personal Information Form, Assessment Form of the Menstrual Cycle Characteristics, and Health-Seeking Behaviour Scale.
    UNASSIGNED: Among all women, 49.7% perceived their menstruation characteristics as \'normal\', and 50.3% perceived them as \'abnormal\'. The menstruation characteristics negatively affected the daily life of 57.6% of women in the normal group and 68.7% of women in the abnormal group. Online health-seeking behaviour was the most common behaviour of seeking remedy; however, professional health-seeking behaviour was inadequate. Among women who perceived their menstruation characteristics as \'normal\', excessive menstrual bleeding, extreme pain, and adverse effects on daily life increased health-seeking behaviour. Among women who perceived their menstruation characteristics as \'abnormal\', irregular cycles, frequent bleeding, low levels of bleeding, the use of too many pads, extreme pain, and adverse effects on daily life increased health-seeking behaviour.
    UNASSIGNED: The participants in this study exhibited insufficient health-seeking behaviour for abnormal menstruation characteristics. Women should be directed by health professionals to reliable online sources to seek help, and they should be encouraged to display professional health-seeking behaviour.
    The knowledge and perception of menstruation characteristics among women is inadequate. The results of this study suggested that many gynecological symptoms that can affect women in their later stages of life may be unintentionally ignored.
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  • 文章类型: Journal Article
    背景:结核病(TB)是导致单一传染病病原体死亡的主要原因之一。赤道几内亚是一个2021年结核病发病率较高的国家(每100,000人口275例),结核病例检出率较低(42%)。早期诊断和及时治疗对于结核病控制至关重要。不寻求适当的医疗保健会增加疾病的传播,并导致不良的治疗结果,死亡率,即使是易于管理的条件。关于赤道几内亚结核病社区管理和寻求治疗模式的信息很少。这项研究的目的是探讨赤道几内亚城市和农村人口结核病病例中结核病寻求健康行为的差异以及与这种行为相关的因素。
    方法:2020年在赤道几内亚使用多阶段分层抽样对770名家庭护理人员进行了一项全国横断面研究。本研究包括报告其家庭中患有结核病例的284名护理人员。创建了实践索引。以实践指数为因变量进行具有稳健方差的泊松回归,以评估与寻求健康行为相关的因素。
    结果:大多数病例(65%)都有良好的结核病寻求健康的做法。然而,23.2%的结核病病例报告在6个月前放弃治疗。观察到女性拥有良好结核病实践的可能性更高,老年人和生活在农村地区。那些结核病人自己在广播中听到了结核病,对结核病有很高的了解,手也是好的做法。
    结论:农村和城市人群在结核病寻求健康行为方面的差异凸显了在抗击这种传染病方面存在的挑战。国家结核病控制计划必须加强卫生系统的需求,以加强对结核病患者的随访,同时考虑到有不适当结核病行为风险的人群。
    背景:不适用。
    BACKGROUND: Tuberculosis (TB) is one of the leading causes of mortality from a single infectious disease agent. Equatorial Guinea is a country with high estimated TB incidence in 2021 (275 cases per 100,000 population) and low TB case detection (42%). Early diagnosis and prompt treatment are crucial for TB control. Failure to seek adequate health care increases the disease\'s transmission and leads to poor treatment outcome, the mortality, even for easily manageable conditions. Information regarding community management of TB and treatment-seeking patterns in Equatorial Guinea is rare. The aim of this study was to explore differences in TB health-seeking behaviour among urban and rural population TB cases in Equatorial Guinea and the factors associated with this behaviour.
    METHODS: A national cross-sectional study of 770 household caregivers was conducted in 2020 in Equatorial Guinea using multistage stratified sampling. The 284 caregivers that reported having had a TB case in their family were included in this study. A practice index was created. Poisson regression with robust variance was performed with the practices index as dependent variable to assess the factors associated with the health-seeking behaviour.
    RESULTS: Most of the cases (65%) have had good TB health-seeking practices. However, 23.2% of TB cases reported having abandoned treatment before 6 months. A higher probability of having good TB practices was observed with being women, aged and living in rural area. Those who were TB cases themselves have heard about TB on the radio, and had high knowledge about TB, hand also good practices.
    CONCLUSIONS: Disparities in tuberculosis health-seeking behaviour between rural and urban populations highlight the challenges existing in the fight against this infectious disease. The National Tuberculosis Control Program has to reinforce the health system needs to strengthen the follow-up of TB patients taking into account the population at risk of inappropriate TB behaviour.
    BACKGROUND: Not applicable.
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  • 文章类型: Journal Article
    在贝宁,孕产妇死亡率仍然很高,每100,000名活产中有397人死亡,尽管80%的分娩由医疗机构的熟练接生员接生。为了确定可能导致这一趋势的分娩方法,在Allada进行了一项关于使用生物医学和替代健康服务的人种学研究,贝宁。数据收集技术包括深度访谈(N=83),非正式面试(N=86),观察(N=32)和小组讨论(N=3)。告密者包括生物医学,精神和替代护理提供者和社区成员,具有各种社会经济和宗教概况。在贝宁南部的另类和精神关怀,受Vodoun的启发,基督教或穆斯林宗教,通常用于生物医学护理。由于分娩被认为是“通往未知的危险旅程”,这些护理方式旨在保护母亲和孩子免受恶意情绪的侵害,使用草药汤剂和精神仪式和仪式促进分娩并限制产后并发症。这些做法是基于对分娩的神秘解释,导致在基于设施的分娩期间需要额外的护理。因为在卫生机构中没有预见到这种补充护理,基于设施的分娩仅在分娩的晚期或在母亲或婴儿感觉到立即危及生命的并发症开始时开始。贝宁降低孕产妇死亡率的方案和政策必须寻求与替代提供者和做法的协同作用,并考虑补充和综合使用无害的替代和精神护理做法。
    In Benin maternal mortality remains high at 397 deaths per 100,000 live births, despite 80% of births being attended by skilled birth attendants in health facilities. To identify childbirth practices that potentially contribute to this trend, an ethnographic study was conducted on the use of biomedical and alternative health services along the continuum of maternal care in Allada, Benin. Data collection techniques included in-depth interviews (N = 83), informal interviews (N = 86), observations (N = 32) and group discussions (N = 3). Informants included biomedical, spiritual and alternative care providers and community members with a variety of socioeconomic and religious profiles. In Southern Benin alternative and spiritual care, inspired by the Vodoun, Christian or Muslim religions, is commonly used in addition to biomedical care. As childbirth is perceived as a \"risky journey to the unknown\", these care modalities aim to protect the mother and child from malevolent spirits, facilitate the birth and limit postpartum complications using herbal decoctions and spiritual rites and rituals. These practices are based on mystical interpretations of childbirth that result in the need for additional care during facility-based childbirth. Because such complementary care is not foreseen in health facilities, facility-based childbirth is initiated only at an advanced stage of labour or at the onset of a perceived immediate life-threatening complication for the mother or baby. Programmes and policies to reduce maternal mortality in Benin must seek synergies with alternative providers and practices and consider the complementary and integrated use of alternative and spiritual care practices that are not harmful.
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  • 文章类型: Journal Article
    尽管越南在孕产妇方面取得了显着改善,新生,和儿童的健康,生活在偏远山区的少数民族的结果继续落后。已经提出了利用该国广泛的移动网络的干预措施,以克服其中一些挑战。进行了一项群集随机对照试验(cRCT),以评估干预措施的有效性,该干预措施包括量身定制的SMS消息,以促进少数民族(EM)孕妇的产前护理知识和行为。在越南北部的八个干预公社(640名妇女)和四个控制公社(315名妇女)实施了cRCT。通过干预前和干预后的问卷调查评估产妇健康相关知识和行为结果以及自我评估的健康状况。差异和逻辑回归分析发现,干预组在对妊娠危险体征和营养补充剂重要性的认识上有明显改善。在寻求产前护理的行为和营养补充剂的摄入量方面取得了显着改善。基于移动消息传递的行为改变干预措施可以显着改善居住在边缘地区的妇女的孕产妇健康相关知识和寻求护理,难以到达的人群。
    Although Vietnam has achieved significant improvements in maternal, newborn, and children\'s health, outcomes for ethnic minorities living in remote mountainous areas continue to lag. Interventions that leverage the extensive mobile networks in the country have been proposed as a way to overcome some of these challenges. A cluster randomised controlled trial (cRCT) was conducted to assess the effectiveness of an intervention comprising tailored SMS messages for promoting antenatal care knowledge and behaviours amongst ethnic minority (EM) pregnant women. The cRCT was implemented across eight intervention communes (640 women) and four control communes (315 women) in Northern Vietnam. Maternal health-related knowledge and behaviour outcomes and self-rated health status were assessed through questionnaires administered pre- and post-intervention. Difference-in-difference and logistic regression analysis found that the intervention group showed significant improvements in awareness about the danger signs of pregnancy and the importance of nutritional supplements. Significant improvements were seen in antenatal care-seeking behaviours and the intake of nutritional supplements. Mobile messaging-based behaviour change interventions can significantly improve maternal health-related knowledge and care-seeking amongst women residing in marginalised, hard-to-reach populations.
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  • 文章类型: Journal Article
    背景:发烧是在东南亚寻求医疗保健的常见原因,疟疾的下降使人们的看法变得更加复杂,以及对它采取了什么行动。我们调查了发烧的概念以及影响泰缅边境移民寻求健康行为的决定因素,在那里,快速的经济发展与不稳定的政治和社会经济条件相冲突。
    方法:我们在2019年8月至12月之间实施了一项混合方法研究。第一阶段采用了定性的方法,深入访谈和焦点小组讨论。第二阶段使用定量方法,并根据第一阶段的调查结果进行封闭式问卷调查。条件推理树(CIT)模型首先确定地理和社会人口统计学决定因素,然后使用逻辑回归模型进行测试。
    结果:发烧与概念的高度多样性相对应,症状和相信的原因。自我药物治疗是发烧时最常见的行为。如果发烧持续,移民主要在人道主义免费诊所寻求护理(45.5%,92/202),其次是私人诊所(43.1%,87/202),卫生站(36.1%,73/202),公立医院(33.7%,68/202)和初级保健单位(30,14.9%)。定性分析确定了距离和法律地位是获得医疗保健的主要障碍。定量分析进一步调查了影响健康寻求行为的决定因素:居住在一个免费诊所经营的城镇附近与在卫生站寻求护理成反比(调整后的优势比[aOR],0.40,95%置信区间[95%CI][0.19-0.86]),和公立医院出勤率(aOR0.31,95%CI[0.14-0.67])。住在离最近城镇更远的地方与卫生站的出勤率有关(每1公里aOR1.05,95%CI[1.00-1.10])。具有法律地位与免费诊所出勤率成反比(aOR0.27,95%CI[0.10-0.71]),与私人诊所和公立医院就诊呈正相关(aOR2.56,95%CI[1.00-6.54]和5.15,95%CI[1.80-14.71],分别)。
    结论:发热的概念和相信的原因是特定的背景,应在任何干预之前进行调查。与护理的距离和法律地位是影响寻求健康行为的关键决定因素。当前的经济动荡正在加速无证移民从缅甸到泰国的无管制流动,保证公共卫生系统的进一步包容性和投资。
    BACKGROUND: Fever is a common reason to seek healthcare in Southeast Asia, and the decline of malaria has complexified how is perceived, and what actions are taken towards it. We investigated the concept of fever and the determinants influencing health-seeking behaviours among migrants on the Thai-Myanmar border, where rapid economic development collides with precarious political and socio-economic conditions.
    METHODS: We implemented a mixed-methods study between August to December 2019. Phase I used a qualitative approach, with in-depth interviews and focus group discussions. Phase II used a quantitative approach with a close-ended questionnaire based on Phase I findings. A conditional inference tree (CIT) model first identified geographic and socio-demographic determinants, which were then tested using a logistic regression model.
    RESULTS: Fever corresponded to a high diversity of conceptions, symptoms and believed causes. Self-medication was the commonest behaviour at fever onset. If fever persisted, migrants primarily sought care in humanitarian cost-free clinics (45.5%, 92/202), followed by private clinics (43.1%, 87/202), health posts (36.1%, 73/202), public hospitals (33.7%, 68/202) and primary care units (30, 14.9%). The qualitative analysis identified distance and legal status as key barriers for accessing health care. The quantitative analysis further investigated determinants influencing health-seeking behaviour: living near a town where a cost-free clinic operated was inversely associated with seeking care at health posts (adjusted odds ratio [aOR], 0.40, 95% confidence interval [95% CI] [0.19-0.86]), and public hospital attendance (aOR 0.31, 95% CI [0.14-0.67]). Living further away from the nearest town was associated with health posts attendance (aOR 1.05, 95% CI [1.00-1.10] per 1 km). Having legal status was inversely associated with cost-free clinics attendance (aOR 0.27, 95% CI [0.10-0.71]), and positively associated with private clinic and public hospital attendance (aOR 2.56, 95% CI [1.00-6.54] and 5.15, 95% CI [1.80-14.71], respectively).
    CONCLUSIONS: Fever conception and believed causes are context-specific and should be investigated prior to any intervention. Distance to care and legal status were key determinants influencing health-seeking behaviour. Current economic upheavals are accelerating the unregulated flow of undocumented migrants from Myanmar to Thailand, warranting further inclusiveness and investments in the public health system.
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  • 文章类型: Journal Article
    印度不断增长的老年人口对他们的医疗服务产生了未满足的需求。为了满足其中一些需求,该研究旨在提供医疗机构利用的现状,寻求健康的行为(HSB),以及影响它们的因素。
    来自印度纵向老龄化研究(LASI)-WaveI的数据用于进行多变量分析,以评估所有年龄段的医疗机构利用率(住院和门诊)与HSB之间的关联。老年人。
    使用公共卫生设施的可能性随着OPD的年龄而增加,而随着IPD的年龄而减少。与其他年龄组相比,80岁及以上老年人的HSB减少了23%。在公共卫生机构中,有健康保险的老年人的医疗服务使用率更高。
    改善印度老年人的健康保险覆盖率可能会改善公共卫生设施中的医疗保健服务。
    UNASSIGNED: The increasing elderly population in India has generated an unmet need for healthcare services concerning them. To address some of those needs, the study aims to provide the current status of health facility utilization, health-seeking behaviour (HSB), and factors influencing them.
    UNASSIGNED: Data from the Longitudinal Ageing Study in India (LASI)-Wave I was used to conduct multivariate analysis to assess the association between health facility utilization (inpatient and outpatient) and HSB across all age groups of the elderly.
    UNASSIGNED: The likelihood of utilizing public health facilities increased with age for OPD and decreased with age for IPD. HSB was 23% less in the 80 years and above elderly as compared to other age groups. Healthcare service uptake was higher in the elderly with health insurance in a public health facility.
    UNASSIGNED: Improving health insurance coverage among the Indian elderly may potentially improve healthcare service uptake in public health facilities.
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