Level of modern health-seeking behavior for common childhood illnesses and its associated factors among mothers of under-five children in southern Ethiopia: A community based study

Background

Health-seeking behavior is an action taken by an individual who perceives to have a health problem. Many childhood morbidities and mortalities are associated with a low level of a mother's healthcare-seeking behavior. However, there are limited studies about modern health-seeking behavior among mothers of ill under-five children in the study area.

Objective

To assess the level of modern health-seeking behavior of mothers/caregivers and associated factors for childhood illness in Hawassa city, Sidama, Ethiopia 2021.

Methods

A community-based cross-sectional study was conducted from November 15 to December 15, 2021, in Hawassa City. Eight kebeles were selected by using simple random sampling methods. A total of 366 mothers with children less than five years were included in this study and an interviewer-administered questionnaire was used to collect data. Data entry, cleaning, and analysis were done by using Statistical Package for Social sciences version 24 and logistic regression was used to determine the presence of association, and significance was declared at p-value <0.05.

Result

The study found that 70.2% of mothers/caregivers seek modern health care for their child's illnesses. Number of Antenatal care follow up ([AOR(Adjusted Odds Ratio) = 2.106; 95% CI(Confidence Interval) (1.097-4.042)), urban residence ([AOR = 2.688; 95% CI (1.403-5.149)), perceived severity of illness ([AOR2.832; 95% CI1.101-7.290)), four or above birth order (5.501; 95% CI (1.761-17.184)) and symptoms guiding severity of illness ([AOR = 4.664; 95% CI (1.918-11.342)) were associated with modern health-seeking behavior.

Conclusion

The overall modern health-seeking behaviors of mothers of under-five children are higher than in previous studies. However, a still significant proportion of mothers do not seek modern health care for their ill children. mothers/caregivers' residence, birth order, number of Antenatal care follow-ups, perceived severity of childhood illness, and perceived guiding symptoms of severity are the significant predictors of mothers' healthcare-seeking behavior.

Behavioral deviations: healthcare-seeking behavior of chronic disease patients with intention to visit primary health care institutions

BACKGROUND

Although primary health care (PHC) has been proven to be effective in preventing and treating chronic diseases, the visits rate of PHC institutions is still not ideal. Some patients initially express a willingness to visit PHC institutions but end up seeking health services at non-PHC institutions, and the reasons for this behavior remain unclear. Therefore, the objective of this study is to analyze the factors that contribute to behavioral deviations among chronic disease patients who originally intended to visit PHC institutions.

METHODS

Data were collected from a cross-sectional survey among chronic disease patients with original intention to visit PHC institutions in Fuqing City, China. The analysis framework was guided by Andersen's behavioral model. Logistic regression models were employed to analyze the factors affecting the behavioral deviations among chronic disease patients with a willingness to visit PHC institutions.

RESULTS

A total of 1,048 individuals were finally included and about 40% of the participants with the original willingness to seek care from PHC institutions finally chose non-PHC institutions in their subsequent visits. The results of logistic regression analyses indicated that at the predisposition factor level, older participants (aOR_60-69 = 0.602, P < 0.01; aOR_70-75 = 0.475, P < 0.01) were less likely to have behavioral deviations. At the enabling factor level, compared to those covered by Urban Employee Basic Medical Insurance (UEBMI) and not reimbursed, those covered by Urban-Rural Resident Basic Medical Insurance (URRBMI) (aOR = 0.297, P < 0.01), and those answering that reimbursement from medical institutions was convenient (aOR = 0.501, P < 0.01) or very convenient (aOR = 0.358, P < 0.001) were less likely to have behavioral deviations. At the need factor level, participants who visited PHC institutions due to illness last year (aOR = 0.348, P < 0.001) and with polypharmacy (aOR = 0.546, P < 0.01) were less likely to have behavioral deviations compared to those without the visit of PHC institutions and not taking polypharmacy, respectively.

CONCLUSIONS

The deviations between the original willingness of PHC institution visits and subsequent behavior among chronic disease patients were associated with a number of predisposing, enabling, and need factors. Developing the health insurance system, strengthening the technical capacity of PHC institutions, and steadily developing a new concept of orderly healthcare-seeking behavior among chronic disease patients, will help promote their access to PHC institutions as well as improve the effectiveness of the tiered medical system for chronic disease care.

Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic

Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.

Elderly people's preferences for healthcare facilities in Shanghai: gender features and influencing factor analysis

BACKGROUND

China has one of the fastest paces of the growing aging population, High-level policymakers have recently recognized the aging population presents significant challenges to the Chinese healthcare system. In this context, the healthcare-seeking behaviors of the elderly population have become an essential field of study. It is necessary to understand their access to health services and to improve their quality of life, as well as to help policymakers to formulate healthcare policy. The study empirically investigates the factors influencing the elderly population's healthcare-seeking behaviors in Shanghai, China, especially in choosing the quality of healthcare facilities to visit.

METHODS

We designed a cross-sectional study. The data of this study were derived from the "Shanghai elderly medical demand characteristics questionnaire" in the middle of November to early December 2017. A total of 625 individuals were included in the final sample. Logistic regression was adopted to investigate the differences in healthcare-seeking behaviors between elderly people when suffer from mild illness, severe illness and follow-up treatment. Next, the differences in gender were also discussed.

RESULTS

Factors affecting the healthcare-seeking behaviors of the elderly differ in mild illness and severe illness situations. For mild illness, demographic factors (gender and age) and socioeconomic factors (income and employment) play an important role in elderly healthcare choices. Female and older elderlies are more likely to choose local, lower-quality facilities, whereas those with high income and private employment are more likely to choose higher-quality facilities. For severe illness, socioeconomic factors (income and employment) are important. Furthermore, individuals with basic medical insurance are more likely to choose lower-quality facilities.

CONCLUSION

This study has shown that the affordability of public health services should be addressed. Medical policy support may be an important way to reduce the gap in access to medical services. We should pay attention to the gender differences in the elderly's choice of medical treatment behavior, consider the differences in the needs of male and female elderly. our findings are only for elderly Chinese participants in the greater Shanghai area.

Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform

BACKGROUND

Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification.

METHOD

A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8^th March 2020 and 7^th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach.

RESULT

The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services.

CONCLUSION

The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.

Mental healthcare-seeking behavior during the perinatal period among women in rural Bangladesh

INTRODUCTION

Mental health conditions are of rising concern due to their increased contribution to the global burden of disease. Mental health issues are inextricably linked with other socio-cultural and health dimensions, especially in the rural areas in developing countries. The complex relationship between mental health issues and socio-cultural settings may largely toll upon healthcare-seeking behavior. So, it urges to document the current status of mental healthcare-seeking behavior during the perinatal period among rural women in Bangladesh to develop a context-specific intervention in the future.

METHODS

This study was carried out in one sub-district in Bangladesh from April 2017 to June 2018. We conducted 21 In-depth Interviews (IDIs) and seven Focus Group Discussions (FGDs) with different groups of purposively selected participants. After collecting the recorded interview and making the verbatim transcription, the data were coded through Atlasti 5.7.a. Data were analyzed thematically to interpret the findings.

RESULTS

Two-thirds of the total respondents did not seek mental healthcare during the perinatal period at the community level. They also did not know about the mental health service provider or the facility to get set these services. Only one respondent out of twenty-one sought maternal mental healthcare from a gynecologist from a private hospital. Socio-cultural factors such as social stigma, traditional beliefs and practices, social and religious taboos, and social capital negatively influence healthcare-seeking behaviors. Besides, the community-level service providers were not found to be adequately trained and did not have proper guidelines regarding its management.

CONCLUSION

The findings provide evidence that there is an urgent need to increase the awareness for service users and formulate a guideline for the community-level service provider to manage maternal mental problems during the perinatal period of women in rural Bangladesh.

Healthcare access: A sequence-sensitive approach

It is widely accepted that healthcare-seeking behaviour is neither limited to nor terminated by access to one single healthcare provider. Yet the sequential conceptualisation of healthcare-seeking processes has not diffused into quantitative research, which continues to analyse healthcare access as a "one-off" event. The ensuing lack of understanding healthcare behaviour is problematic in light of the immense burden of premature death especially in low- and middle-income countries. This paper presents an alternative approach. Based on a novel survey instrument, we analyse original survey data from rural India and China that contain 119 unique healthcare pathways among 637 respondents. We offer three applications of how such sequential data can be analysed to enhance our understanding of people's health behaviour. First, descriptive analysis of sequential data enables more a comprehensive representation of people's health behaviours, for example the time spent in various healthcare activities, common healthcare pathways across different groups, or shifts in healthcare provider access during a typical illness. Second, by analysing the effect of mobile technology on healthcare-seeking process characteristics, we demonstrate that conventional, sequence-insensitive indicators are potentially inconsistent and misleading approximations when compared to a more precise, sequence-sensitive measure. Third, we describe how sequential data enable transparent and flexible evaluations of people's healthcare behaviour. The example of a sequence-insensitive evaluation suggests that household wealth has no statistical link to an illustrative "ideal" form of public healthcare utilisation. In contrast, sequence-sensitive evaluations demonstrate that household wealth is associated with an increased likelihood of bypassing referral processes and approaching unregulated and costly informal and private practitioners before accessing a public clinic. Sequential data therefore do not only reveal otherwise neglected locational idiosyncrasies, but they also yield deeper insights into the drivers of people's health behaviours compared to a conventional approach to "access to healthcare."

Healthcare-seeking preferences of patients with sexually transmitted infection attending a tertiary care center in South Kerala

BACKGROUND

Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs.

METHODS

Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities.

RESULTS

Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant (P = 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector.

CONCLUSION

Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.

Healthcare-seeking behaviors for acute respiratory illness in two communities of Java, Indonesia: a cross-sectional survey

Understanding healthcare-seeking patterns for respiratory illness can help improve estimations of disease burden and inform public health interventions to control acute respiratory disease in Indonesia. The objectives of this study were to describe healthcare-seeking behaviors for respiratory illnesses in one rural and one urban community in Western Java, and to explore the factors that affect care seeking. From February 8, 2012 to March 1, 2012, a survey was conducted in 2520 households in the East Jakarta and Bogor districts to identify reported recent respiratory illnesses, as well as all hospitalizations from the previous 12-month period. We found that 4% (10% of those less than 5 years) of people had respiratory disease resulting in a visit to a healthcare provider in the past 2 weeks; these episodes were most commonly treated at government (33%) or private (44%) clinics. Forty-five people (0.4% of those surveyed) had respiratory hospitalizations in the past year, and just over half of these (24/45, 53%) occurred at a public hospital. Public health programs targeting respiratory disease in this region should account for care at private hospitals and clinics, as well as illnesses that are treated at home, in order to capture the true burden of illness in these communities.

Healthcare-seeking preferences of patients with sexually transmitted infection attending a tertiary care center in South Kerala

BACKGROUND

Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs.

METHODS

Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities.

RESULTS

Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant (P = 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector.

CONCLUSION

Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.

Impact of eating attitude and impairment of physical quality of life between tertiary clinic and primary clinic functional dyspepsia outpatients in Japan

BACKGROUND/AIMS

There is no available data on factors associated with healthcare-seeking behavior for functional dyspepsia (FD) symptoms at ei-ther tertiary or primary clinics in Japan. Therefore, we aimed to compare clinical symptoms and life styles such as sleep dis-orders and eating attitude in FD patients visiting general practitioners at primary clinics with those consulting gastro-enterologists at tertiary clinics to clarify healthcare-seeking patterns in Japanese patients.

METHODS

Fifty-one FD outpatients in a tertiary clinic (college hospital), 50 FD outpatients visiting primary clinics and 50 healthy volunteers were enrolled. Clinical symptoms, quality of life, sleep disorders, eating attitude and anxiety were estimated using the Gastroin-testinal Symptom Rating Scale (GSRS), Social Functioning-8 (SF-8) test, Pittsburg Sleep Quality Index (PSQI) test and State-Trait Anxiety Inventory (STAI) for FD outpatients and healthy volunteers.

RESULTS

FD outpatients exhibited higher mean scores of GSRS than healthy volunteers. The SF-8 physical component summary scores in the tertiary clinic group were significantly lower than those in the primary clinic group. GSRS scores were significantly (P < 0.001, P = 0.002) associated with global PSQI scores in FD outpatients as well as with STAI-trait scores (P = 0.006, P = 0.001) compared to healthy volunteers. The frequency of eating between meals in the primary clinic group was significantly (P < 0.05) higher than that in the tertiary clinic group.

CONCLUSIONS

It may be important for clarification of healthcare-seeking behavior to determine the difference in both impairment of physical quality of life and eating attitudes between tertiary clinic and primary clinic FD outpatients in Japan.(J Neurogastroenterol Motil 2014;20:506-515).

Influenza-like illness, the time to seek healthcare, and influenza antiviral receipt during the 2010-2011 influenza season-United States

BACKGROUND

Few data exist describing healthcare-seeking behaviors among persons with influenza-like illness (ILI) or adherence to influenza antiviral treatment recommendations.

METHODS

We analyzed adult responses to the Behavioral Risk Factor Surveillance System in 31 states and the District of Columbia (DC) and pediatric responses in 25 states and DC for January-April 2011 by demographics and underlying health conditions.

RESULTS

Among 75 088 adult and 15 649 child respondents, 8.9% and 33.9%, respectively, reported ILI. ILI was more frequent among adults with asthma (16%), chronic obstruction pulmonary disease (COPD; 26%), diabetes (12%), heart disease (19%), kidney disease (16%), or obesity (11%). Forty-five percent of adults and 57% of children sought healthcare for ILI. Thirty-five percent of adults sought care ≤ 2 days after ILI onset. Seeking care ≤ 2 days was more frequent among adults with COPD (48%) or heart disease (55%). Among adults with a self-reported physician diagnosis of influenza, 34% received treatment with antiviral medications. The only underlying health condition with a higher rate of treatment was diabetes (46%).

CONCLUSIONS

Adults with underlying health conditions were more likely to report ILI, but the majority did not seek care promptly, missing opportunities for early influenza antiviral treatment.

Prevalence, Risk Factors, Quality of Life, and Health-Care Seeking Behaviors of Female Urinary Incontinence: Results From the 4th Korean National Health and Nutrition Examination Survey VI (2007-2009)

Purpose

There is a lack of information on female urinary incontinence (UI) in South Korea. We investigated the prevalence, risk factors, quality of life (QoL), and healthcare-seeking behaviors of women with UI.

Methods

We included 9,873 women over the age of 20 years who had participated in the Korea National Health and Nutrition Examination Survey IV. The condition of UI was defined as answering "yes" to the question "Do you have UI?" Additionally, health care seeking behavior for UI was defined as answering "yes" to "Have you ever been treated for UI?' The EuroQoL-5 Dimension (EQ-5D) descriptive system was used to evaluate QoL.

Results

The mean age of our sample was 49.7 years. The overall prevalence of UI was 7.9%. The prevalence of UI significantly increased with age. The rate of healthcare-seeking behavior for UI also significantly increased with age. However, the rate of healthcare seeking for UI was significantly lower when compared to the prevalence of UI. In our multivariate analysis, age, body mass index, and marriage were significantly and independently associated with UI. As the severity of all the subscales of EQ-5D increased, the unadjusted odds ratio for UI also increased. After adjusting for potential confounders, the subscales of mobility, usual activities, pain/discomfort, and anxiety/depression from the EQ-5D were significantly associated with UI.

Conclusions

UI is a common disease and is significantly associated with QoL. Our results suggest the need for developing preventive measures and treatment policies for UI.