[Self care of common health disorders: results of a telephone survey of the general population]

BACKGROUND

Self-care of health problems including self-medication, constitutes the most frequent response to the most common acute symptoms in several studies carried out in other countries. Indeed there are few data concerning the scope of self-care in Spain.

METHODS

A telephone survey was carried out by a questionnaire of response limited to a sample of 660 homes in the city of Barcelona. In each home response was required by only one person between the ages of 15 and 80 on the common symptoms experienced within the previous 30 days and their behavior in response to the same.

RESULTS

In 448 homes response was obtained from adults on the habits of self-care or medical consultation in episodes of headache, lumbalgia, colds, diarrhea, fever or dysmenorrhea registered the previous month. The global rate of response was 70% with a higher number of refusals among men. Headache (42.8%), lumbalgia (41.7%) and colds (34.4%) were the most frequent symptoms with self-medication including physical and home remedies being the most common response.

CONCLUSIONS

Self-care for minor health problems is frequent in the population studied. The type of symptom in addition to age and sex appear to be the most important determining factors in this behavior.

[Tuberculosis in a primary care center in a socioeconomically depressed area: variables associated with giving up treatment]

We report the features of 72 patients with tuberculosis of a low socioeconomical level, seen at the primary care center of Perecamps (Barcelona). We identify the factors associated with giving up therapy. We found a predominance of males and of the 40-59 years age group. In 1988 we found an increased rate of young patients (20-39 years) and PDA/HIV+. Twenty-five patients (35%) had had previous episodes of tuberculosis. 19 had had inadequate chemotherapy because of abandonment. The rate of follow-up losses was high (36%). A history of previous PDA/HIV+ were associated with giving up therapy. We indicate the several measures to be applied in our area to improve compliance with chemotherapy in patients with tuberculosis.

[The reasons for medical and nursing appointments in a primary health care center (Barcelona)]

The programmed visit, which is basically generated by the health care team, permits a rationalization of the demand and the introduction of health promoting activities. We have evaluated our motives (medical and nurse practices) for the appointment of patients during 1987. We have also recorded the age, sex, compliance and source of the appointment in a sample of 198 medical and 223 nurse appointments. 62.5% of the appointed visits corresponded to females and more than 50% to patients over 59 years. The most common type of appointment was to control chronic disease, owing to its high prevalence and the protocolization of its care. In individuals under 45 years appointments were mostly for diagnostic approach and to record the clinical history. The implementation of preventive measures appeared as one of the least common causes. Failure to comply was seen in 25%, being higher in patients under age 45 and in the appointments to record the clinical history. These results point to the need of restructuring the concertation priorities. The health problems of the population and its vulnerability are the factors that should guide health planning.

[Human immunodeficiency virus infection at a primary care center]

We report a descriptive study of 56 cases of HIV infection in a primary care center to evaluate its impact on the population on care, the practices at risk, the associated infections and the difficulties for control. The distribution by age, sex and practices at risk is in agreement with most series from our area. Remarkably, there is a greater rate of drug abusers and sexual promiscuity, related with the marginal type of population on care. We found a high prevalence of the most commonly associated infections, tuberculosis, syphilis and hepatitis B. This association justifies screening for these diseases and the use of the adequate prophylactic and therapeutic measures. We found important difficulties for the follow up of these patients. All these facts emphasize the need to approach this increasing health problem from the primary care setting, basically from the health education of the person with practices at risk and the overall follow-up of the involved patients.