Journal articles on the topic 'Self-perception. Sick Health behavior'

Introduction: Tuberculosis (Tb) is one of the 10 causes of death worldwide. Indonesia ranks third in the world . This indicates that the behavior of prevention of transmission by Tb patients is not effective yet. The purpose of this study is to identify behavioral factors for preventing TB transmission based on the Health Promotion Model theory.Method: This research was conducted by using descriptive analytic design with cross sectional approach. Population of this research was 150 patient with Tb. Sample on this research was 108 respondents which were chosen by using simple size calculator technique. Independent variables in this research were behavior before sickness, cognizance of patient of Tb, perceived of benefits, perceived of barriers, self-efficacy, attitudes related to transmission prevention activitie and environmental influences. Dependent variable in this research prevention behavior of TB transmission. The data colleting technique used in this research was questionnaire which was analysed by Spearman’s rho test with <0,05 significance. Result: The result showed that preventive behavior of TB transmission was correlated with behavior before sick (r=0.239), cognizance of patient of TB (r=0.261), perceived of benefits (r=0.371), and family support (r=0.284). There was no correlation between perceived of barriers (r=-.113), self-efficacy (r=0,160), attitudes related to transmission prevention activities (r=-.097) and environmental influences (r=0.034). With preventive behavior of TB transmission.Conclusion: Behavior of TB prevention is also influenced by behavioral factors before illness, knowledge of Tb, perception about the benefits of actions and family support. The Puskesmas was expected can improve Health Education by giving education about how to use mask well and shelter provision sputum in TB infection prevention behaviors in society.

A healthy lifestyle, including health behavior, illness behavior, as well as sick role behaviorplay a key role in managing type 2 diabetes mellitus (T2DM) as well as limiting its complications. This qualitative descriptive with case study research design utilized a type 2 diabetes mellitus patient who had good Self-Management Diabetes aims to describe the formation of health behavior in patients with type 2 diabetes mellitus reviewed by using Protection Motivation Theory (PMT). PMT consists of five components, namely the Severity, Vulnerability, Response Effectiveness, Self Efficacy, and Fear. Results suggest that the five components in PMT can be used to predict behavioral intentions that are highly related to one’s behavior, and the information either from the environment or intrapersonal plays a role in giving results in the formation of behavioral intentions to make changes in lifestyle, which leads to the emergence of health behaviors.

The Roma community (RC) has poor health indicators, and providing them with adequate healthcare requires understanding their culture and cultural differences. Our objective was to understand the concept of the health and sickness of the RC in Spain, and for this, a qualitative study was conducted. A content analysis utilizing an inductive approach was used to analyze the data. Twenty-three semi-structured interviews were performed, and four main categories were obtained after the analysis of the data: perception of the state of health, the value of health, what was observed, and causal attribution. The inter-relations between the categories shows that the RC have a dichotomous worldview split between non-sickness (health) and sickness mediated by causal attribution. Their worldview is polarized into two values: not sick/sick. When not sick, optimism is prioritized along with happiness, and these two emotions are highly valued, as they also play a physical and social function. When a person becomes noticeably sick, this is understood as being in a negative and severe state, and when there are visible physical implications, then the need to act is made clear. When faced with the need to act, the behavior of the RC is mediated by causal attributions, influenced by nature and religion, timing, concealment by not mentioning the disease, and the origin of the healthcare information. For the organization of an adequate health response for the RC, it is necessary for healthcare systems to be able to merge culture and health care.

Background. Poor, delayed, or inappropriate health seeking for a sick infant with acute childhood illness is associated with high morbidity/mortality. Delay in health seeking is implicated with fatal complications and prolonged hospital stay. Thus, caregivers ought to identify danger signs and promptly seek professional help for a sick infant. Objective. Establish determinants of health seeking behavior among caregivers of infants admitted with acute childhood illnesses in Kenyatta National Hospital. Methods. A mixed method cross-sectional study involving caregivers (n=130) of sick infants. Semistructured questionnaire and two focused group discussions were used to gather data on caregiver knowledge on danger signs, health care seeking options, and decision-making regarding health care seeking. Data was analyzed with SPSS V. 22. Results. Knowledge of danger signs of infancy was poor. Immediate health seeking was associated with tertiary [P=0.009] and secondary [P=0.030] education, knowledgeability on danger signs [P=0.002], and being married [P=0.019]. Respondents who resided in urban [P=0.034] or less than a kilometer [P=0.042] from a health facility sought care immediately. Those who rated services as excellent (P=0.005) and satisfactory (P=0.025) sought care promptly. Conclusion. Poor knowledge on danger signs of infancy was common among caregivers blurring the magnitude of acute illness resulting in delayed health seeking. Knowledgeability of danger signs of infancy, high educational level, and being married were associated with immediate health care seeking. Caregivers who resided in urban setting and/or near a health facility were linked to immediate health seeking. Additionally, satisfaction and perception of quality health care services were associated with immediate health seeking. Interventions with caregivers should involve capacity building through partnership with families and communities to raise awareness of danger signs of infancy. Strengthening of health care system to offer quality basic health services could improve health seeking behavior. Provision of a seamless supply system, infrastructural support, and technical support for soft skills minimize the turnaround time which is critical.

OBJECTIVES/SPECIFIC AIMS: To access obesity risk perceptions, knowledge and behaviors of Hispanic taxi cab drivers and develop a better understanding of the factors that influence health outcomes in this population. METHODS/STUDY POPULATION: Focus groups were conducted at NYC H+H/Lincoln, where subjects were screened and recruited from taxi bases with the help of the local Federation of Taxi Drivers. This was done by utilizing flyers, messages through taxi-base radios, and referrals from livery cab drivers. Approval from the local Institutional Review Board was obtained. The research investigators, developed a structured focus group procedural protocol of open-ended interview questions related to cardiovascular disease. Participants for the focus groups were older than 18 years old and working as livery cab drivers in NYC for at least 6 months. Three focus groups were held with informed consent obtained from each participant in their primary language before the start of each session. After completion of the focus group, participants received a gift voucher for attending the approximately 1-hour session. Focus groups were moderated by trained research staff members at Lincoln. Three main categories of questions were organized based on perception, knowledge, and behavior. Participants were questioned on topics about obesity, CVD and diabetes knowledge; knowledge about etiology, risk perception, possible prevention and interventions. Responses were recorded using audiotapes and transcribed verbatim. If participants did not elaborate on the initial question, a probing question was asked to clarify. The transcript was translated from Spanish by trained bilingual staff and analyzed using standard qualitative techniques with open code method. Four research investigators read the transcript separately and formulated concepts, which were then categorized and formulated into dominant themes. These themes were then compared and analyzed with a group consensus to ensure representative data. Once recurring themes emerged and the saturation point was reached, the study concluded, after enrolling 25 participants. The Health Believe Model (HBM) was employed to understand and explain the perceptions and behaviors of taxi drivers. HBM is one of the most widely recognized models and is used to understand, predict and modify health behavior. HBM helps to identify perception of risks of unhealthy behavior, barriers for having healthy behavior, actions taken by patients to stay healthy, self-efficacy and commitment to goals [12]. RESULTS/ANTICIPATED RESULTS: Of the 25 Hispanic livery cab drivers, 92% were male. The majority of taxi drivers that participated in the study were immigrants (96%), with a mean age of 53 years (ranged 21–69), and 92%, were spoke Spanish. In total, 52% participants identified themselves as Hispanic, 20% White, 4% Black, and 20% did not identify their race. Mean body mass index (BMI) was 31 (22.8–38.7) kg/m2. In all, 56% were obese and another 40% were overweight. From this sample, 50% had been diagnosed with hypertension and 27% were living with diabetes. In all, 64% had a high school education or higher. Answers provided by the taxi drivers to focus group questions were recorded, reviewed and divided into 8 dominant themes based on concepts that emerged from the focus groups discussions. (a) Focus group study findings: Themes recorded during the focus group discussions, include poor diet, sedentary lifestyle, comorbidities/risk factors, stress, health not being a priority, discipline, education, and intervention. Participants shared their opinions in regards to these themes with minimal differences, making an emphasis on the fact that the nature of their profession was the root cause. Of the themes, the top 3 dominant themes include poor diet, sedentary/lifestyle and comorbidities/risk factors. (1) Diet: The theme “Poor diet” evolved from 151 related concepts that were described by participants. All 25 participants perceived their diet as bad due to eating high-fat meals associated with the cultural food and restaurant chains with lower food prices and ease of car parking. Drivers also reported that they did not have enough time to eat healthy foods based on their long working hours. They say: “comemos muy tarde por que preferimos montar un pasajero” … stating that they preferred to pick up passengers and delay their meals. However, they consider poor diet as the most decisive factor in their increased risk for obesity, diabetes, and hypertension. (2) Life Style: The theme “Sedentary lifestyle” was derived from 147 similar concepts described by participants. They believe that physical inactivity is another leading risk factor for obesity, diabetes, and CVD. The demands of the profession force them to drive more than 10 hours per day. They understand the importance of daily exercise but they admit that at the end of the workday they are too tired to exercise or “stop working” to participate in exercise as this means less money. They also understand that family history of obesity in addition to poor diet increases their risk of obesity, diabetes, and cardiovascular risks. (3) Comorbidity: The theme “Comorbidities” developed from 143 concepts grouped together. Taxi-drivers perceived that obesity complications directly affects many vital organs, such as the kidneys, the heart, and vasculature. Participants perceive obesity as important risk factor for high blood sugar and cholesterol levels. Taxi drivers see an association between their health condition and their work as a taxi driver. However, taxi-drivers reported that they are more concerned about the economic well-being of their families than themselves. Taxi-drivers begin to intervene in their own health only when more serious health conditions related to obesity, diabetes, and hypertension developed. (4) Work Stress: The theme “Stress/other risk factors” was derived from 141 concepts. Taxi-drivers perceive their profession with lack of organization and high-stress levels as one of the leading risk factors contributing to obesity, diabetes, and cardiovascular disease. They also attribute a combination of stressful lifestyle, poor diet, lack of exercise, consumption of alcohol and cigarettes as determining factors in developing negative health outcomes. “One participant says; Tenemos el paquete completo” … we have the entire package. (5) Health as a priority: The theme “Health is not a priority” was derived from 120 concepts based on the cab drivers’ responses. Taxi drivers prioritize their work while their health takes a back seat. They work long shifts as they feel the pressures of financial responsibilities of their family. They admitted lack of intentions to change their behavior and they consider themselves as “hard headed.” Drivers changed their behavior only when serious health conditions develop that require professional medical attention. Taxi drivers explain that the lack of time as being a big factor in pursuing preventative care. (6) Personal Discipline: The theme “Discipline” evolved from 80 concepts derived from the driver’s transcripts. Taxi drivers are aware of their lack of organizational skills in general, especially when it comes to the balance between work and a healthy lifestyle. Taxi drivers recognize that not being disciplined results in the development of their obesity and chronic health conditions. Drivers admit that they do not have a fixed schedule, with no direct supervision, and cannot find the time to go to the doctor or change their behavior. (7) Health Education: The theme “Education” was derived from79 concepts noted from the focus group discussion. Taxi drivers know that their lack of health education is affecting them. With little understanding about the severity of the disease process it is difficult to take proactive measures. They are interested in the development of programs that will educate them about obesity, diabetes and CVD prevention. They want to attend programs that can educate them about prevention of obesity, diabetes, and CVD prevention with strong focus on healthy eating. They understand that this would increase their ability to change their unhealthy behavior. (8) Health interventions: The last major theme “Intervention” was derived out of 71 concepts. When asked about possible interventions that might help them towards healthy behaviors, taxi drivers think that the use of technology as a means of education is very effective. They understand the most direct route to reach them is by cellphone, email, and social media such as Facebook. They also feel that it would be good to use this type of communication to not only to inform them about health issues, but to also educate them directly. (b) Application of Health Behavior Model: We employed the HBM, one of the most utilized and easy to understand health models (18, 20–22) to explain the knowledge, perception, and health behaviors of our study participants. The HBM consist of 6 posits: (1) risk susceptibility, (2) risk severity, (3) benefits of action, and (4) barriers to action, (5) self-efficacy, and (6) cues to action [23]. According to the HBM, people’s beliefs about their risk and their perception of the benefits of taking action to avoid it, influence their readiness to take action [15, 21–22, 24]. Using the HBM, health behavior can be modified positively if the 6 posits are perceived by the person [23]. According to the results of our study, taxi drivers that participated in our study, do not perceive the severity of their risk. Participants admitted that they go to the doctor and start paying attention to their health condition only when they get seriously sick. Another posit of the HBM, understanding benefit of actions, is also not perceived by taxi drivers. Participants understand that they should be involved in physical activity, but do not pursue physical activity. They stated that they are too busy and tired to exercise daily without realizing the benefits of having a healthy life style. Findings from the focus groups also demonstrate that taxi drivers do not possess self-efficacy, as they are not confident that they are able to change their own health behavior. They openly admitted to having poor discipline, lack of organizational skills, and lack of time management skills. But, they expressed their wish to get information about time management, healthy snacks, places where they can get affordable and healthy food, learn more about different physical activities, and places where they can exercise. The sixth posit of the HBM model is the cues for action which should trigger the action to change behavior. Cues such as physical pain or illness in them or family members of cab drivers, trigger a visit to the physician’s office. Cab drivers were open to receiving educational material provided by physicians or health information provided on TV/cellphone about disease prevention. DISCUSSION/SIGNIFICANCE OF IMPACT: Obesity is steadily on the increase in the US population and has become a major public health concern [1–3]. Latinos are at the higher risk of heart diseases such as obesity, hypertension compared to other ethnical groups [3, 13]. There is a higher prevalence of obesity among particular occupational groups with cab drivers having one of the highest obesity prevalence among all professions [5, 7–9, 13]. Obesity risks therefore seem to affect NYC cab drivers who are of Latino background more than others. Surveys conducted in different countries in Asia, Europe, and Africa reported that taxi, truck, and bus show that drivers are at a higher risk of developing obesity, diabetes, and hypertension [5, 8–11]. This study is the first to evaluate the knowledge, perception, and behaviors of NYC Latino taxi cab drivers with respect to obesity. The study uncovers factors and barriers that contribute to their behavior, and identify possible ways that can modify their behavior and decrease their chances of developing obesity. The study results demonstrated that Latino immigrant taxi drivers perceive themselves at a high risk for obesity development. As the result of discussions with focus groups, the eight dominant themes were identified. Participants perceive their risk susceptibility and understand that working as a driver is a sedentary occupation with lack of physical activity significantly contributing to obesity development. Additionally, taxi drivers report that their unhealthy diet is a major factor that contributes to their weight gain. Taxi drivers perceive their poor diet as the result of the food they consume being high in fat content. Due to financial constraints and their cultural diet requirements, they feel limited to unhealthy food options. They acknowledge the risk that poor diet contributes to obesity, high cholesterol, obesity development. Participants also expressed that work stress is another important factor. Busy traffic, lack of organization, financial stress to support their families-push them to work prolonged hours. Participants also admitted that in their leisure time, they use alcohol, smoke cigarettes, and watch TV, instead of going to the gym, because they feel too tired to exercise. Taxi drivers perceive their barriers as a lack of education and knowledge about healthy food choices, places where they can buy healthy affordable snacks, information about physical activities, stress management skills, and organizational skills. Other perceived barriers that prevent them from leading healthy lifestyle include lack of discipline, lack of time for physical activity, economic uncertainty, financial responsibility and the perception that the wellbeing of their families is more important than themselves and their health. HBM is a widely used model that helps to identify perception of risks of unhealthy behavior, barriers to healthy behavior, actions taken by patients to stay healthy, self-efficacy, and commitment to goals. Based on the Glasgow theory, the core of health behavior models is the identification of the barriers and self-efficacy [25]. Our study is unique as it involves using the HBM to explain the basis of taxi cab drivers’ behavior. Results of our research study showed that our participants perceived barriers very well. However, lack of self-efficacy, lack of perceiving benefits of action, lack of cues to action, and lack of understanding the risk of disease severity explain why taxi drivers have greater risk for obesity among occupations, and are not ready to embrace health behavior modification. This qualitative study shows us where the window of opportunity for intervention lies, how we can intervene and modify the health behavior of the at-risk NYC Latino cab driver population. By Glasgow theory, self-efficacy is an important factor in behavior modification models [25]. If the barriers that are perceived by participants as too high, and self-efficacy is low, one can intervene by improving self-efficacy. Bandura has offered ways to increase patients’ self-efficacy by using three strategies: (a) setting small, incremental, and achievable goals; (b) using formalized behavioral contracting to establish goals and specify rewards; and (c) monitoring and reinforcement, including patient self-monitoring by keeping records [20]. We can also improve perception of the benefits of action by providing cues to action namely education during the office visits, by providing reading materials, and the use of modern technology (emails, interactive Web sites, apps, etc.). A study was conducted in South Asia, encouraging taxi drivers to exercise through the use of pedometers [7]. This study provides an example of ways to motivate taxi drivers, improve their self-efficacy, overcome barriers, and provide cues to action. As one of the theories that can explain and help in behavioral modification, the Health Belief model includes the impact of the environment and elements of social learning. Using this model, we were able to differentiate and identify the factors that influence their behavior that need to be addressed by health care workers and public health representatives to improve obesity related risks among inner city taxi cab drivers in NYC.

ABSTRACTObjective:Both trait and contextual self-concealment, as well as shame- and guilt-proneness, have previously been found to be associated with psychological distress. However, findings regarding the associations between these variables among patients with cancer and among the spouses of patients with cancer are limited. The aim of the current study was therefore to investigate the relationship between shame-proneness and psychological distress (anxiety and depression) by examining the mediating role of both trait and contextual self-concealment among patients with cancer and among the spouses of patients with cancer.Method:The current study was part of a large-scale cross-sectional study on self-concealment among patients with cancer and spouses of patients with cancer. It was based on two independent subsamples: patients with cancer and spouses of patients with cancer,who were not dyads. A total of 80 patients with cancer and 80 spouses of (other) patients with cancer completed questionnaires assessing shame- and guilt-proneness, trait and contextual self-concealment, anxiety, and depression.Results:Results indicate that spouses reported both greater shame-proneness and anxiety than did patients (main effect of role). Female participants reported greater shame-proneness, higher levels of contextual self-concealment, and greater depression and anxiety than did male participants (main effect of gender). No group differences (role/gender) were found for guilt-proneness and trait self-concealment. Trait and contextual self-concealment partially mediated the relationship between shame-proneness and distress, pointing out the need to further examine additional mediators.Significance of results:Findings suggest that contextual self-concealment and shame-proneness are important variables to consider when assessing distress in the setting of psycho-oncology. Study results may have significant clinical implications regarding the need to identify patients and spouses who are more prone to shame and self-concealment behavior in order to better tailor interventions for them.

Background: Literature revealed that men tends to use healthcare services much lesser and visit much later, resulting in poor health outcomes. This is often regarded as a way of exhibiting masculinity. In Brunei, there is an increasing number of mortality resulting from the complication of diabetes mellitus, a non-communicable disease, which arguably can be prevented.Objectives: To explore their health-help seeking behavior and health maintenance pattern of male diabetic patients in Brunei.Methods: Qualitative research guided by phenomenology research design. COREQ Checklist was used to prepare the report of this study. Individual semi-structured interview on eleven men were conducted from February to November 2018. Interviews were audio-recorded, transcribed and analyzed thematically.Results: Three themes were developed: “Maintaining health to enable the performance of masculine roles”, “Men delay seeking healthcare services”, and “Maintaining control and self reliance in looking after own sick body”. Conclusion: Health is perceived as important - it enables men to perform their ‘masculine responsibilities’. When men are in ill-health and realized how this could jeopardize their masculine roles, they would actively involve in taking care of their own body. This suggested how masculinity is in fact context –dependent. Level of knowledge and experiences with healthcare services and treatments also influenced men decision in health-help. Despite evidence that suggests how men often decline involvement with health promoting activities and delay seeking health from healthcare professionals, it was found that being able to continue supporting their family act as a legitimate reason for them to access healthcare services.

The Medicine students need to increase their research skills. Therefore, there is a main goal to train the fifth year students in epidemiological analysis methods during educational activities in work hours. In the Tula Aguilera Health Area, the fifth year Medicine students conducted a control-case study, where they applied a 14 questions survey to 69 persons sick with infectious diarrhea during June to December 2013. The results were compared to those of 131 healthy persons. The survey collected demographic, environmental and lifestyle variables. For each factor found, odd ratios (OR) were determined and the behavior of the analyzed variables was compared in both groups with the logistic regression technique. The basic reproductive number (Ro) was determined considering its impact and a simulation was compared with the usual historical dispersion of those diseases. Among the results, the students were trained to gather information and to transfer data to Excel Worksheets to analyze causal relationships. The students, after analyzing, were able to establish that the surveyed population had a low risk perception, they were also able to establish and calculate differences between sick and healthy people; for instance, people who don’t cover solid wastes and become sick have nearly three times more risk (OR=2.81; IC 1.34-6.03), moreover the students were able to demonstrate the presence of environmental hazards. They found that the survey was reliable and became familiar with the usage of the basic reproductive number and derived simulations. We conclude that the designed training allowed the students to increase their skills during the educational practices at work regarding the learning by doing research methodology. The trainig strategy is valid, sustainable, updated and of great value in the Medicine students instruction.

The ArgumentPain has important biomedical socioanthropological, semiotic, and other facets. In this contribution pain and the experssion of pain are looked at from the perspective of evolutionary biology, utilizing, among others, cross-cultural data from field work in Melanesia.No other being cares for sick and suffering conspecifics in the way humans do. Notwithstanding aggression and neglect, common in all cultures, human societies can be characterized as empathic, comforting, and promoting the health and well-being of their members. One important stimulus triggering this caring response in others is the expression of pain. The nonverbal channel of communication, particularly certain universal — i.e., culture-independent facial expressions, gestures, and body postures, convey much of the message from the painstricken person to the group.These behaviors signal the person's physical and psychical pain, sadness, grief, and despair in ways very similar to the signs given by infants and small children: the body loses tonus and sinks or drops to the ground, the gestures are those of helplessness. Pain and grief may be so strong that control is lost not only over the body's posture but also over the mind's awareness. In such cases the afflicted person may carry out actions endangering himself or others. In general, these behavior patterns resemble those of infants in situations of distress and danger, and it is not surprising that the response of the members of the group is basically parental: taking care, assisting and consoling.Perceptive and behavioral patterns which developed in the course of avian and mammalian phylogeny to serve the well-being of the young have proven, as was shown by Eibl-Eibesfeldt (1989), to be powerful building blocks for actions in other spheres of human interaction. Love is one such field, the reactions to a conspecific suffering pain is another.

Background:One of the greatest challenges of the COVID-19 pandemic for rheumatologists concerns the patient’s adherence to treatment (1). The impact of poor adherence on the effectiveness of chronic disease treatment is severe in terms of poorer health outcomes and increased health care costs (2). Information regarding covid-19 on adherence behavior in Latin-American is scarce.Objectives:The aim of this study is to describe impact of COVID-19 outbreak on adherence behavior in Latin-American population with rheumatic diseases.Methods:We carried out a descriptive, cross-sectional, self-report study through voluntary telephonic survey, to determine adherence behaviors during the COVID-19 pandemic, from September 9th, 2020 to November 19th, 2020, for consecutive patients of the outpatient rheumatology clinic in the Hospital Universitario (Monterrey, Nuevo Leon, Mexico), which serves a resource limited population that lack access to health insurance, from five neighboring states. A 17-items survey was designed. Baseline demographics that were collected included age, sex, rheumatologic diagnosis, current medications and patient perception of disease control. Patients were asked if they continued follow-up care, last prescribed therapy and reasons. Also, the survey assessed whether patients had any issues with medication supply and where they were obtaining information about covid-19 (could choose as many options as applicable). Transferred to SPSS for analysis for descriptive statistics.Results:A total of 150 patients were called, the survey response rate was 54.6% (n=82), with a mean completion time of 10 minutes. The mean +/- SD age of the participants was 52 +/- 15.9 years, and 95% were female. The most common self-reported diagnoses were rheumatoid arthritis (RA) (13.4%) and systemic lupus erythematosus (SLE) (13.4%) [Table 1]. Patient perception of disease control was primary good 37.8% and regular 35.4%.Patients that continued their follow-up with their rheumatologist (on the clinic face-to-face, electronically or telehealth) or in another clinic were 26.9%, the majority were nonadherent 73%. Persistence to treatment was 82.9%, the main reason to discontinue therapy was lack of prescriptions or medical advice 8.5% and overall 58.5% had trouble finding their medicine.Information regarding covid-19 was mainly obtained by television (health secretary conference) 90.2%, and the least directly from their doctor 4.8%.Table 1.Survey ResultsN (%)Age, mean +/- SD years 52 +/- 15.9Female/ Male78 (95.1) / 4 (4.9)DiagnosesRA50(61)SLE11(13.4)Osteoarthritis10(12.2)Other11(13.4)Disease Control during covid-19Excellent8 (9.8)Good31 (37.8)Regular29 (35.4)Bad14 (17.1)Continued follow-up(face-to-face, telehealth, other)22 (26.9)Continued last prescribed treatment68 (82.9)Reasons to discontinue treatmentLack of prescriptions/ medical advice7 (8.5)Lack of availability6(7.3)Economic disadvantage3 (3.6)Fear of getting sick of COVID-192(2.4)“Trouble” finding medicine48 (58.5)COVID-19 informationTelevision (Health Secretary conference)74 (90.2)Social network27 (32.9)Newspaper/ magazines14 (17)Internet9 (10.9)From a doctor4 (4.8)Conclusion:Patients continue their therapeutic regimen, still many of them have trouble finding their medications, which affects the disease control. Also, despite having a poor disease control (majority between regular and bad) they are not continuing their follow-up care, more objective studies are needed to determine a specific cause.References:[1]Pineda-Sic RA, Galarza-Delgado DA, Serna-Pena G, et al. Ann Rheum Dis Epub ahead of print: [20-06-2020]. doi:10.1136/ annrheumdis-2020-218198[2]Anghel, L. A., Farcaş, A. M., & Oprean, R. N. (2018). Medication adherence and persistence in patients with autoimmune rheumatic diseases: a narrative review. Patient preference and adherence, 12, 1151–1166. https://doi.org/10.2147/PPA.S165101Disclosure of Interests:None declared

A majority of emerging infectious diseases (EIDs) are zoonotic, mainly caused through spillover events linked to human-animal interactions. We conducted a survey-based human behavioral study in Laikipia County, Kenya, which is characterized by a dynamic human-wildlife-livestock interface. Questionnaires that assessed human-animal interactions, sanitation, and illnesses experienced within the past year were distributed to 327 participants among five communities in Laikipia. This study aimed to 1) describe variation in reported high-risk behaviors by community type and 2) assess the relationship between specific behaviors and self-reported illnesses. Behavioral trends were assessed in R via Fisher’s exact tests. A generalized linear mixed model with Lasso penalization (GLMMLasso) was used to assess correlations between behaviors and participants’ self-reported illness within the past year, with reported behaviors as independent variables and reported priority symptoms as the outcome. Reported behaviors varied significantly among the study communities. Participants from one community (Pastoralist-1) were significantly more likely to report eating a sick animal in the past year (p< 0.001), collecting an animal found dead to sell in the past year (p<0.0001), and not having a designated location for human waste (p<0.0001) when compared to participants from other communities. The GLMMLasso revealed that reports of an ill person in the household in the past year was significantly associated with self-reported illness. Sixty-eight percent of participants reported that bushmeat is available within the communities. Our study demonstrates community-level variation in behaviors that may influence zoonotic pathogen exposure. We further recommend development of targeted studies that explore behavioral variations among land use systems in animal production contexts.

Background: Newborn mortality in Cambodia remains high, with sepsis and complications of delayed care-seeking important contributing factors. Intervention study objectives were to improve infection control behavior by staff in health centers; improve referral of sick newborns; increase recognition of danger signs, and prompt care-seeking at an appropriate health facility; and appropriate referral for sick newborns by mothers and families of newborn infants. Methods: The stepped-wedge cluster-randomized controlled trial took place in rural Cambodia from February 2015 to November 2016. Sixteen clusters consisted of public health center catchment areas serving the community. The intervention included health center staff training and home visits to mothers by community health volunteers within 24 h of birth and on days 3 and 7 after delivery, including assessment of newborns for danger signs and counselling mothers. The trial participants included women who had recently delivered a newborn who were visited in their homes in the first week, as well as health center staff and community volunteers who were trained in newborn care. Women in their last trimester of pregnancy greater than 18 years of age were recruited and were blinded to their group assignment. Mothers and caregivers (2494) received counseling on handwashing practices, breastfeeding, newborn danger signs, and prompt, appropriate referral to facilities. Results: Health center staff in the intervention group had increased likelihood of hand washing at recommended key moments when compared with the control group, increased knowledge of danger signs, and higher recall of at least three hygiene messages. Of mother/caregiver participants at 14 days after delivery, women in the intervention group were much more likely to know at least three danger signs and to have received messages on care-seeking compared with controls. Conclusions: The intervention improved factors understood to be associated with newborn survival and health. Well-designed training, followed by regular supervision, enhanced the knowledge and self-reported behavior of health staff and health volunteers, as well as mothers’ own knowledge of newborn danger signs. However, further improvement in newborn care, including care-seeking for illness and handwashing among mothers and families, will require additional involvement from broader stakeholders in the community.

The objective of the study was to assess the health seeking behavior of the people regarding complementary and alternative medicine (CAM) in remote area Dhudhakaushika, Gaunpalika of Solukumbu District during April – August 2017. The sample size was 300 (129 male and 171 female). Semi-structured question was design and Focus Group Discussion (FGD) was conducted. The results indicated that about three fourths of the respondents visited a modern medical institution 224 (74.7%), a little under one-half 129 (43.0%) visited Dhami-Jhakri and 85 (28.3%) contacted the Jharphuke who chanted a Mantra over a sick adult or child. Around 33 (11.0%) contacted the female community health volunteer (FCHV), 20 (6.7%) used domestic medicine or ethno- medicine, 13 (4.3%) visited a pharmacy and 9(3.0%) visited a private allopathic clinic when they felt discomfort. Respondents ascribed the cause of the disease to supernatural causes or evil spirits (53.3%), to germs (48.7%), curse of God (83.0%) to sins committed in the past (10.3%), and other causes (5.7%). The respondents usually consulted at first Dhami-Jhakri (43.0%) and Jharphuke (28.3%) when they fell sick. People utilized CAM in order to relieve undesired pain, uneasiness in the body and restore the health condition. The types of alternative medicine utilized by the respondents were Ayurveda 162 (54.0%), jadi-booti 248 (82.7%), homeopathy 94 (31.3%), relaxation 33 (11.0%), and meditation 68 (22.7%) healing touch 55 (18.3%), therapeutic massage 109 (36.3%), acupuncture 126 (42.0%), acupressure 44 (14.7%) Yoga 28 (3.3%) and 10 (3.3%) did not know any practice other than Dhamijhakri. Through the FGD, it was observed that traditional medicine sector was an important source of health care in Solukhumbu. The main reasons for consulting a CAM healer were the proximity, affordable barter system, availability, family pressure and the strong opinion of the community. In conclusion, CAM use especially self-treatment with medicinal plants was found to be a common practice along with modern medicine in a rural setting in Nepal. The study findings emphasized the reality of multiple recourse adopted by health care seekers and their deeply entrenched belief in CAM. Nepal has a very rich tradition in the use of medicinal plants for the treatment of various ailments. This may indicate the need for the integration of the modern and CAM systems in terms of evidence-based information sharing. This calls for bringing CAM healers into the mainstream by providing them with proper training, facilities and referral services. The healers can motivate the persons to access modern health care services by placing a Tika of ash (Kharani) prior to referral. A positive interaction between the two systems has to be harnessed to work for the common goal of improving health of the people.

The author uses data from the 1987 National Medical Expenditure Survey to investigate the extent and determinants of gender differences in days lost from work due to illness. She finds that for both men and women, health status measures, such as self-reported health status and medical events, more consistently explained absenteeism than did economic factors such as wages and the presence of sick leave. The presence of young children increased women's, but not men's, probability of missing work, as well as women's number of absences for those who missed work in 1987. Among men who were absent from work in 1987, however, the presence of children in day care increased the number of days lost from work. In that regard, those men, most of whom were likely to be either single parents or married with a working wife, behaved more like mothers with young children than like other men.

BACKGROUND: Schizophrenia is a clinical syndrome that is variable, but highly disturbing; its psychopathology involves cognition, emotion, perception, and other aspects of behavior. Schizophrenic patients who are hospitalized, who return to a family environment characterized by high levels of criticism, excessive emotional involvement, or hostility (referred to as high expressed emotion), are more likely to experience the recurrence than schizophrenic patients returning to families characterized by low expressed emotion. AIM: We aimed to investigate relationship between caregiver burden and expressed emotion in families of schizophrenic patients. METHOD: This research is an analytic study with a cross-sectional approach. The research site is in the outpatient installation of BLUD Mental Health Hospital of North Sumatra Province using consecutive sampling non-probability sampling. The samples are family members who carry schizophrenic patients go to an outpatient installation at the BLUD Mental Health Hospital of North Sumatra Province that meets the inclusion and exclusion criteria. RESULT: The burden of care for the families of the most schizophrenic patients was mid load as many as 36 people, namely 36%, light burden of 34 people, 34%, no burden of 18 people, 18%, and heavy burden of 12 people, 12%. There is a significant relationship between the burden of treatment with expressed emotion, which is 0.004 (p < 0.05). CONCLUSION: In this study showed a significant relationship between the burden of treatment with expressed emotion (p = 0.004). This study is in accordance with the study conducted by Darwin in 2013, and Carra in 2012, which showed that there was a significant relationship between the burdens of treatment with expressed emotion in the families of schizophrenic patients. Other studies also show that the burden of care has an impact on emotional, physical health, social life, and financial status as a result of caring for sick people.

ABSTRACTBackgroundImpulsivity is a psychological trait linked to health issues such as obesity. However, few studies have explored the relation between impulsivity, dietary intake, and eating disorders (EDs) in a general population.ObjectiveThe aim of this cross-sectional study was to assess whether impulsivity was associated with energy intake, food-group consumption, snacking, and risk of EDs.DesignIn 2014, 51,368 adult participants from the NutriNet-Santé Study completed the 11th version of the Barratt Impulsiveness Scale (BIS-11), which assesses impulsivity. Food-group consumption and diet quality were evaluated by using ≥3 self-reported 24-h dietary records (n = 35,830), whereas snacking behavior was evaluated by an ad hoc question (n = 48,562). Risk of EDs was assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF), and categories of ED (restrictive, bulimic, hyperphagic, and other types of EDs) were determined with the Expali algorithm (n = 48,824). Logistic and linear regressions were used to analyze the associations between impulsivity and energy intake, food-group consumption, diet quality, snacking, and risk of EDs, taking into account sociodemographic and lifestyle factors.ResultsPositive associations were found between impulsivity and consumption of alcoholic beverages and appetizers, whereas negative associations were found for fruit and vegetables, meat and poultry, processed meat, dairy products, milk-based desserts, and starchy foods. Impulsivity was positively associated with energy intake and negatively associated with diet quality. Impulsivity was also positively associated with snacking (OR: 3.32; 95% CI: 2.99, 3.68) and risk of EDs (OR: 3.02; 95% CI: 2.74, 3.33). The strongest associations were found for bulimic disorders (OR: 4.38; 95% CI: 3.66, 5.23) and hyperphagic disorders (OR: 2.91; 95% CI: 2.56, 3.31).ConclusionImpulsivity was associated with food intakes, snacking, and risk of EDs and could be taken into account in the promotion of healthy eating behavior. This study was registered at clinicaltrials.gov as NCT03335644.

AbstractIntroductionOperational stress describes individual behavior in response to the occupational demands and tempo of a mission. The stress response of military personnel involved in combat and peace-keeping missions has been well-described. The spectrum of effect on medical professionals and support staff providing humanitarian assistance, however, is less well delineated. Research to date concentrates mainly on shore-based humanitarian missions.ProblemThe goal of the current study was to document the pattern of operational stress, describe factors responsible for it, and the extent to which these factors impact job performance in military and civilian participants of Continuing Promise 2011 (CP11), a ship-based humanitarian medical mission.MethodsThis was a retrospective study of Disease Non-Battle Injury (DNBI) data from the medical sick-call clinic and from weekly self-report questionnaires for approximately 900 US military and civilian mission participants aboard the USNS COMFORT (T-AH 20). The incidence rates and job performance impact of reported Operational Stress/Mental Health (OS/MH) issues and predictors (age, rank, occupation, service branch) of OS/MH issues (depression, anxiety) were analyzed over a 22-week deployment period.ResultsIncidence rates of OS/MH complaints from the sick-call clinic were 3.7% (4.5/1,000 persons) and 12.0% (53/1,000 persons) from the self-report questionnaire. The rate of operational stress increased as the mission progressed and fluctuated during the mission according to ship movement. Approximately 57% of the responders reported no impact on job performance. Younger individuals (enlisted ranks E4-6, officer ranks O1-3), especially Air Force service members, those who had spent only one day off ship, and those who were members of specific directorates, reported the highest rates of operational stress.ConclusionThe overall incidence of OS/MH complaints was low in participants of CP11 but was under-estimated by clinic-based reporting. The OS/MH complaints increased as the mission progressed, were more prevalent in certain groups, and appeared to be related to ship’s movement. These findings document the pattern of operational stress in a ship-based medical humanitarian mission and confirm unique ship-based stressors. This information may be used by planners of similar missions to develop mitigation strategies for known stressors and by preventive medicine, behavioral health specialists, and mission leaders to develop sensitive surveillance tools to better detect and manage operational stress while on mission.ScoutenWT, MehalickML, YoderE, McCoyA, BrannockT, RiddleMS. The epidemiology of operation stress during Continuing Promise 2011: a humanitarian response and disaster relief mission aboard a US Navy hospital ship. Prehosp Disaster Med. 2017;32(4):393–402.

We can identify five important needs that children have: the need for acknowledgment, acceptance, awareness or attention, respect, and care. If these needs are not met, children will modify themselves by denying central parts of their nature in order to adjust to their parents and the situation at large. When a child denies his or her talents, powers, and gender or aspects thereof, he or she loses quality of life, the ability to function, and physical or mental health. The loss of ability takes the form of diminished social ability, psychosexual potency, joy, energy, and fantasy while playing, as well as diminished ability to concentrate, focus, and learn. Many modifications result in a child with severely damaged self-confidence, self-worth, and poor performance. A child more or less deprived of self-worth cannot enjoy, give, or receive. A child deprived of emotions turns cold, rational, asocial, socially stiff, uncomfortable, and in the extreme case ... intentionally “evil”. When a child denies his or her own sex, it becomes invisible, uninteresting, and vague or becomes like the opposite sex in behavior and appearance. The general holistic solution to the vast diversity of symptoms in children with low quality of life is to improve the situation for the child and give the child the holding and support he or she needs. It is very important to realize that a negative belief often has survival value to the child as it helps the child to avoid taking responsibility for problems, which really belong to the parents or other adults. Children have a fine capability for spontaneous healing, and seem to enter this process more easily than adults, given sufficient holding. The symptoms of children with poor thriving ability are often difficult to understand, as they are caused by a complex combination of self-modification in five existential dimensions. This often leads to complex medical diagnosis, giving the idea that the child is sick and without therapeutic reach, while sufficient holding could solve the problem. If holding and support of the child is not enough, the situation must be carefully analyzed to find other possible causes of poor quality of life, health, and functional ability. Education of the parent in holding is often mandatory. Most children with bad thriving ability can thus be helped by simple means.

Background: Depression is one of the most common mental disorders affecting people in the world. It is also a growing concern in younger population particularly medical students. There are many pharmaceutical interventions for treatment of depression but there is paucity of data to determine the effect of educational intervention on the knowledge, attitude and help seeking behaviour regarding depression among medical students. Methods: An interventional study was carried out among randomly selected 100 medical students except interns over a period of 6 months from March-August 2011 in a medical college in Delhi to assess the effect of educational booklet on knowledge and attitude about depression. Data was collected using pre-tested questionnaire and analyzed using SPSS version 16 software. Statistical significance in pre and post intervention proportions was determined using Mc Nemar test (MN) and for other proportions Chi-square test.Results: The study shown that only 71% of subjects knew that depression is a disease in pre intervention phase, which rose to 88% in post intervention phase (p=0.01). Knowledge of symptoms and treatment significantly improved such as trouble falling asleep or too much sleep (p=0.03), feeling tired or decreased energy (MN=17.6, p=0.01), feeling bad about self (MN=21.8, p=0.01), speaking slowly other can notice (MN=19.1, p=0.01) and can be treated by improving awareness (MN=8.6, p=0.03), and anti-depressants do not cause much of side effects (MN=17.3, p=0.01). Most common reasons for not seeking help were thinking that there is lack of understanding by other people about the depression (63%), lack of confidentiality (49%), social stigma (30%), fear of rejection (26%) and time constraints (6%). Majority of students accepted the booklet for their understanding about depression where 63% considered that it improved their knowledge to great extent. Conclusions: Educational interventional booklet should be promoted at bigger level to help students to identify and understand the depression which may improve health seeking behavior and could decrease their suffering if they fall sick.

Abstract Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases (LHL)’s 2015 Health Survey (N = 2689), this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual lifestyle, political orientation and health condition. We found a moderate support for social responsibility across political views. Respondents reporting unhealthier eating habits, smokers and physically inactive were less supportive of health promotion policies (including information, health incentives, prevention and regulations). The idea that individuals are responsible for taking care of their health was widely accepted as an abstract ideal. Yet, only a third of the respondents agreed with introducing higher co-payments for treatment of ‘self-inflicted’ conditions and levels of support were patterned by health-related behaviour and left-right political orientation. Our study suggests that a significant support for social responsibility does not exclude a strong support for personal health responsibility. However, conditional access to healthcare based on personal lifestyle is still controversial.

Most models of health-related behaviors are based on the assumption that people estimate the seriousness of a risk, evaluate the costs and benefits of action, and then select a course of action that will maximize their expected outcome. Risk refers to the possibility of loss and is generally conceived as consisting of two components: the probability and the severity of negative outcomes. This article focuses on the probability component. First the role of perceived risk in models of health-behavior will be discussed. Possible biases in risk-perception and the role of perceived risk as a determinant of protective behavior are the next issue. This is followed by some methodological considerations about how to measure perceived risk and investigate its role as a behavioral determinant. Next we turn to optimistic biases in comparative risk appraisal and briefly discuss both antecedents and consequences of optimism. Finally we discuss some implications of these findings for programs aiming to change health-related behavior and increase protective action.

ABSTRACTThe end of the ‘Golden Age’ of welfare capitalism in the 1970s was the prelude to a period of greater individualisation within societies and was accompanied by an increase in the importance of consumption as a way of organising social relations. During the same period there was also an expansion in the discourses aimed at enhancing the government of the autonomous self. One such discourse operates around what has been termed the ‘will to health’: it suggests that health has become a required goal for individual behaviour and has become synonymous with health itself. The generational groups whose lifecourses were most exposed to these changes are now approaching later life. We explore the extent to which social transformations related to risk, consumption and individualisation are reflected in the construction of later-life identities around health and ageing. We examine how the growth in health-related ‘technologies of the self’ have fostered a distinction between natural and normal ageing, wherein the former is associated with coming to terms with physical decline and the latter associated with maintaining norms of self-care aimed at delaying such decline. Finally, we consider anti-ageing medicine as a developing arena for the construction of later-life identities and discuss the implications of the social changes for researching later life.

In several areas, Kentuckians practice more risky health behaviors than most of the rest of the nation. The Health Belief Model states that individuals with lower perceived risks practice less healthy behaviors. This study sought to determine if this was true for food safety by assessing food safety perceptions and behaviors of Kentucky consumers. Data were collected through a telephone questionnaire based on a survey by the U.S. Food and Drug Administration; 728 respondents participated. Food safety perceptions were analyzed by examining participants' responses to confidence in the safety of the food supply, perception of likelihood of people becoming sick because of foodborne illness, and perception of where food safety problems are most likely to occur. Significant differences were found in food safety perceptions for age, gender, household income, education, and employment in the food industry. Analysis of food safety behaviors revealed differences in food handling behaviors for gender, education level, household income, race, and households with a member aged 65 years or older. Significant relationships were found between respondents' food safety perceptions and behaviors. In general, Kentucky consumers who perceived higher risks exhibited safer food handling behaviors. Strategies to increase the understanding of real and perceived food safety risks in the home combined with strategies that target specific demographic groups may be the most effective approach to improve food handling practices. A better understanding of consumers' food safety risk perceptions and behaviors could lead to more effective food safety education materials and messages.

AbstractBackground:This correlational study explored the psychosocial aspects related to eating behavior in different age samples of adolescents in treatment from 0 to 60 months at the Clinic of Orthodontics and Dentistry of Messina, Messina, Italy. The aim of the study was to investigate the relationship between psychosocial impact, levels of self-esteem, and the possible connection with eating habits of adolescents under orthodontic treatment.Methods:Sixty-one adolescents, aged between 12 and 22 years (mean=15.6±2.8) participated to the study. Each adolescents was interviewed with the Eating Attitudes Test, the Rosenberg Self Esteem Scale, and the Psychosocial Impact of Dental Aesthetics Questionnaire.Results:Data did not show a direct connection between eating disorder and dental aesthetics, nevertheless, adolescents under orthodontic treatment, especially in the earliest phase of wearing braces, showed peculiar eating habits and underwent a higher psychological impact of dental aesthetics. Eating behaviors are strictly linked to global self-esteem. The processing of the results was made through the Student’s t-test and using Pearson’s correlation analysis.Conclusion:Increased knowledge of the psychological aspects involved in orthodontic treatment compliance may have positive effects in the relationship between adolescent patients and orthodontists. More attention should be paid to aspects that are often underestimated in clinical practice, thus, influencing the outcome of treatment and patient satisfaction, not only in terms of dental health, but also of mental health.

Purpose: To test the hypothesis that differences between sicker and not-so-sick women in their preoccupation with their illness and parenting behavior can explain why some investigators find that children of breast cancer patients fare better than controls and other investigators find the reverse. Patients and Methods: Forty-two women with metastasized breast cancer (sicker mothers) and 45 women with a first occurrence of nonmetastasized breast cancer (not-so-sick mothers) rated the degree of their preoccupation with the disease, their parenting behavior, mood, and social supports and the emotional and behavioral symptoms in one of their children. Their 12- to 18-year-old children rated their mothers’ parenting behavior, their own emotional and behavioral symptoms, and their self-esteem. Results: Sicker mothers reported relatively less preoccupation. They, and their children, reported less poor parenting and fewer externalizing symptoms in the children. Regression analyses revealed further differences between the groups. Conclusion: Less preoccupation with their illness and less poor parenting behavior by sicker mothers may explain why their children seem to fare better then those of not-so-sick mothers. Formulations concerning families of breast cancer patients should include consideration of the effect of the mothers’ perception of the severity of their illness.

Health care seeking behaviour of a mother has an important role in reducing morbidity and mortality related common childhood illness amongst under-five children. The main objective of this study was to identify the health care seeking behaviour of mothers who attended tertiary level hospital in Kathmandu for common childhood illness. The study was conducted in the paediatrics out-patient department of Tribhuvan University Teaching Hospital Kathmandu by employing a descriptive design under the quantitative research approach. Similarly, a non-probability convenience sampling technique was used in the study in which 151 mothers having 0-24 months (0-2 years old) children attending in OPD were included. Prior to data collection, written approval of the proposal was obtained from Research Department and Institutional Re­view Board, Institute of Medicine and Director of TUTH. The data were collected with the help of interview schedule and analyzed by using descriptive statistics. Result of this study found that 85.4% mothers had information regarding common childhood illness. All respondents were found seeking care when their children got sick. Out of the total respondents, 90% of them took their children in health facility whereas remaining 10% took their children to the traditional healer for treat­ment. Out of the total respondents taking their children in health facility, 80.8% mentioned that the children’s condition was worsened and, among them 65.4% preferred government health facility. Reason for not taking to health facilities were far distance, expensive treatment, lack of money, lack of faith and mothers’ perception of severity of illness. From this study, it can be concluded that the service provided through government health facilities needs to be improved and focus should be given on health education to mother regarding common childhood illness and its severity. Likewise, it is also necessary to increase mothers’ positive attitude and perception toward medical treatment when a child gets sick.

Abstract Self-perception of aging may affect the interpretation of health-related changes that influence behaviors. Understanding how self-perception of aging is associated with healthy behavior, stress, and health is essential to prepare healthy aging. The purposes of this study are to examine the influence of healthy behavior on stress and subjective health status and to investigate whether self-perception of aging affects the association in midlife Koreans. This is a cross-sectional study. Data were collected through a self-administered survey using a convenience sampling of 466 midlife Koreans (mean age = 50.7, 52.4% male). The PROCESS macro for SPSS was applied for data analysis. Self-perception of aging was significantly related to stress (r= .20, p&lt;.00), and subjective health was related to healthy behavior (r= .22, p&lt;.00) and stress (r= -.38, p&lt;.00). Healthy behavior predicted stress, which, in turn, affected subjective health status (index=.05, 95% CI [.01, .10]). A significant interaction between healthy behavior and self-perception of aging was found (β= -.22, p=.002), indicating that the influence of healthy behavior on stress was different depending on the individual’s self-perception of aging. It means that the impact of healthy behavior on stress was stronger in individuals with a more negative self-perception of aging. The findings demonstrate the critical role of self-perception of aging, which affects the benefits of healthy behavior on stress and subjective health status. This study highlights the importance of assessing self-perception of aging and developing cognitive behavioral interventions that contribute to modifying stereotyped beliefs about aging for better quality of life in midlife.

Abstract Gender variations in health literacy have implications for engagement in preventive behaviours and the uptake of health services, especially in areas such as the Caribbean where there are marked disparities in life expectancy and health service utilization. A self-reported questionnaire was used to examine men’s concepts of health, their help-seeking behaviours and their functional and interactive health literacy. Two hundred and forty-eight men across the life course participated at three sites in Trinidad. Data were analysed using descriptive statistics, with free-text responses analysed thematically. Men were concerned about, and accepted responsibility for their own health but social norms concerning sickness and masculinity were barriers to accessing health services. Almost one-third (31.5%) sought advice from a healthcare service when they were last sick because they were prompted to do so by their wife/partner or family. Levels of functional and interactive health literacy were not high among older men, who were reliant on healthcare professionals to communicate health messages. There was an age divide in e-health literacy. There is little published evidence on men’s health literacy, particularly from Caribbean countries such as Trinidad and Tobago. This study highlights the importance of the design and implementation of specific policies focusing on men’s health. A major challenge is to engage with men who do not access health services.

Menurut Anderson R (1968) dalam behavioral model of families use of health services, perilaku orang sakit berobat ke pelayanan kesehatan secara bersama-sama dipengaruhi oleh faktor predisposisi (usia, jenis kelamin, pendidikan, pekerjaan), faktor pemungkin (ekonomi keluarga, akses terhadap sarana pelayanan kesehatan yang ada dan penanggung biaya berobat) dan faktor kebutuhan (kondisi individu yang mencakup keluhan sakit).Penurunan utilisasi atau jumlah pasien rawat inap yang jika dibandingkan pada semester 1 tahun 2013 (bulan Januari 2013 sampai dengan Juni 2013) dengan semester 1 tahun 2012 (bulan Januari 2012 sampai dengan Juni 2012) menunjukan penurunan sebanyak 0,87%. Penelitian ini bertujuan untuk mengetahui factor-faktor yang berhubungan dengan keputusan pasien rawat inap dalam memilih pelayanan rawat inap di RS Pertamina Cirebon tahun 2014. Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan desain penelitian cross sectional dengan populasi penelitian adalah seluruh pasien rawat inap dalam satu bulan sebanyak 492, sedangkan jumlah sampel yang diambil sebanyak 100 dengan metode pengambilan non random sampling yang menggunakan teknik quota sampling. Hasil penelitian diperoleh bahwa faktor karakteristik pasien yang memiliki hubungan dengan keputusan pasien untuk memilih pelayanan rawat inap hanya karakteristik sosial pengaruh kelompok acuan, sedangkan faktor karakteristik pasien (pendidikan, pekerjaan, keadaan ekonomi, dan cara pembayaran), faktor sosial keluarga, faktor budaya tidak ada hubungan dengan keputusan untuk memilih pelayanan rawat inap. Faktor psikologi pasien yang memiliki hubungan dengan keputusan untuk memilih pelayanan rawat inap hanya persepsi terhadap bauran pemasaran SDM dan proses, sedangkan faktor lainnya seperti motivasi, pembelajaran, bauran produk, harga, tempat, promosi, dan bukti fisik tidak ada hubungan dengan keputusan untuk memilih pelayanan rawat inap di RS Pertamina Cirebon.Kata Kunci : karakteristik pasien, psikologi, keputusan pasien ABSTRACTAccording to Anderson R (1968) in behavioral models of families use of health services, the behavior of the sick medical treatment to the ministry of health jointly influenced by predisposing factor (age, gender, education, employment), enabling factor (economi families, access to the means of the existing health services and treatment costs of the insures), and the reinforcing factors (condition of the individual that includes complaints of pain). Utilization decline or in-patient number that when compared in semester of 1 years 2013 (January 2013 inclusive Juni 2013) with semsester of 1 years 2012 (January 2012 inclusive Juni 2012) shows declineas much 0,87%. This research aimed to know factors that related to in-patient decision in selecting service in-patient in Rumah Sakit Pertamina Cirebon years 2014. Research used inquantitative with cross sectional with a population was all patients hospitalized in one month as much as 492, while the number of samples taken as many as 100 by the method of making non-random sampling using quota sampling technique. The results showed that the factor characteristics of patients who have a relationship with the patient’s decision to choose inpatient services only social characteristics influence the reference group, while the factor of patient characteristics (education, employment, economic conditions, and method of payment), family social factors, cultural factors do not exist relationship with the decision to choose inpatient services. Psychological factors of patients who have a relationship with the decision to choose in patient only the perception of the marketing mix of human resources and processes, while other factors such as motivation, learning, product mix, price, place, promotion, and physical, evidence of no association with the decision to choose a service pertamina hospital patient in Cirebon.Keywords : patient characteristics, psychology, patient decision.

Symptoms after inflammatory activation, so-called sickness behaviour, overlap with trans-diagnostic complaints. As no self-report questionnaire to assess sickness behaviour exists, we aimed to develop such an instrument, the Sickness Questionnaire. Items responsive to experimentally induced inflammatory activation (randomized double-blind study endotoxin (0.6 ng/kg) versus placebo, n = 52) were selected and the statistical properties were examined in 172 primary care patients. A principal component analysis indicated a one-factor solution (Cronbach’s alpha = .86). This 10-item scale correlated with depression ( β = .41, p < .001), anxiety ( β = .36, p < .001), self-rated health ( β = .28, p < .001) and a single item of feeling sick ( β = .55, p < .001). The results support the adequacy of Sickness Questionnaire as a brief assessment instrument of perceived sickness behaviour.

ObjectivesWe aimed to provide an integrated picture of the relationship between different facets of adverse social behaviour (ASB) at the workplace and sick leave.MethodsData from a randomly drawn prospective cohort of the general working population. Eligible respondents were interviewed in 2009, 2013 or 2016, and were registered with an employee relationship of at least 50 working days in the national register the year following the survey interviews (n=21 674 observations/13 470 respondents). We investigated the prospective associations of self-reported exposure to ASB, including threats/acts of violence, bullying and sexual harassment, with physician-certified sick leave of 1–16 days (ie, low level of sick leave (LLSL)) and >16 days (ie, high level of sick leave (HLSL)) by means of mixed effects logistic regression.ResultsThe prevalence of sick leave was 18.4% (n=3986 observations) for LLSL and 16.1% (n=3492 observations) for HLSL. The different facets of ASB were independently associated with higher odds of sick leave, with stronger associations for HLSL than for LLSL. Adjusted for sex, age, education level, occupation, previous sickness absence level, OR (95% CI) for HLSL was 1.97 (1.61 to 2.35) for threats/acts of violence, 1.97 (1.53 to 2.54) for bullying and 1.41 (1.10 to 1.79) for sexual harassment. The population risks of LLSL and HLSL attributable to ASB were 5.27 (95% CI 1.85 to 8.81) and 8.27% (95% CI 4.01 to 12.48), respectively.ConclusionsThreats/acts of violence, bullying and sexual harassment were all independent predictors of sick leave, with threats/acts of violence appearing as the single most important factor.

The health and economic consequences of the COVID-19 pandemic is expected to disproportionately impact residents of lower-middle income countries. Understanding the psychological impact of the pandemic is important to guide outreach interventions. In this study, we examined people’s awareness of COVID-19 symptoms, risk perception, and changes in behaviors and stress levels during the lockdown in peri-urban Tamil Nadu India. Field workers conducted phone call surveys (included n = 2044) in 26 communities from 20–25 May 2020. The majority perceived no (60%) or low (23%) level of risk of personally contracting coronavirus. Common fears were related to health and economic concerns, including loss of income (62%), inability to travel freely (46%), and becoming sick (46%). Residents were well aware of the common symptoms of COVID-19, such as fever (66%) and dry cough (57%), but not the asymptomatic transmission (24%). The majority experienced increased stress about finance (79%) and the lockdown (51%). Our findings emphasize the need to develop context-adequate education and communication programs to raise vigilance about asymptomatic transmission and to sustain preventative behaviors. The evidence on fear and changes in stress levels could inform designing coping strategies and programs focused on mental well-being.

Background: Diabetes mellitus (DM) is a major health problem in the world. DM patients should be able to perform self-care behavior. Diabetic self-care behavior is an effective strategy for controlling diabetes.Objective: The purpose of this study was to examine a health promotion model in patients with type 2 diabetes mellitus.Methods: A cross-sectional design was used, which involved 177 patients with type 2 diabetes from primary health care in Denpasar Bali Indonesia with a stratified random sampling. Independent variables were personal factors (age, sex, education, body mass index, socioeconomic status, self-motivation, illness perception, and belief), self-efficacy, and family support. The dependent variable was self-care behavior. A structural equation model was used to confirm the hypothesis model.Results: Personal factors (education, socioeconomic, and perceptions) (t = 2.891) and family support (t = 5.746) were associated with self-care behavior. Self-efficacy did not affect self-care behavior (t = .139).Conclusion: Diabetes self-care behavior is influenced by socioeconomic status, level of education, perception of the illness, and family support. Therefore, it is suggested for nurses to apply the health promotion model approach to increase self-care behavior of patients with type 2 diabetes mellitus.

Background: The aim of this paper is to expand the knowledge on the subject matter of the relations between behavior that is geared towards health and the feeling of effectiveness in the context of martial arts tourism in the form of Taekwon-do training summer camps. Method: The research encompassed 58 people (32 men and 26 women) who train Taekwon-do (ITF) (aged: 26.36 ± 8.97; scope: 18–45 years of age). The measurement of the feeling of effectiveness and healthy behavior was conducted by means of standardized tools, including the General Self-Efficacy Scale. Results: The analyzed fighters who participated in the research in the majority of the sports meetings declared a higher level of the feeling of effectiveness (p < 0.001). Through cluster analysis emerged two groups, with a significant difference between self-efficacy (mean value of 20.05 points in contrast to 33.93 points in the second group). The group with higher psychological indices values attended a higher amount of summer camps during their practice history (at least two camps attended in the second cluster). Conclusion: Sports tourism connected with martial arts, as exemplified by training groups (professionally organized training camps) of Taekwon-do (ITF), is connected with the increased feeling of personal effectiveness, while also serving the enhancement of psycho-physical health, well-being, and the development of social skills.

1 This study aims to investigate the extent of passive smoking exposure of sick children in Hong Kong; their father' smoking behaviors and their mother' action to protect the child from environmental tobacco smoke (ETS). 2 This cross-sectional survey was the first phase of a randomized controlled trial on a health education intervention provided by nurses in the general paediatric wards of four major hospitals in Hong Kong. The subjects are non-smoking mothers of sick children admitted to hospital and with a smoking husband living together in the same household with the child. Eligible subjects completed a self-administered baseline questionnaire before entering into the trial. 3 All the 848 children whose mothers completed the questionnaire during December 1997 to April 1998 had a smoking father. They constituted about 24% (95% CI: 22.6-24.9%) of all the sick children during the same period. More than half of the children' fathers (55%; 51.6-58.3%) smoked 1-14 cigarettes per day and about 68% (64.7-71.0%) of them were daily smokers for over 10 years. Over half (53%; 49.4-56.2%) of the fathers smoked 1-14 cigarettes at home every day. About 21% of the fathers smoked near the child occasionally and 31% (27.4-33.6%) smoked 1-14 cigarettes near the child per day. About 16% of the children lived with more than one smoker (2-3). About 86% (83.3-88.0%) of the children had 1-3 smokers who smoked at home and 61% (58.1-64.7%) of them had 1-3 smokers who smoked near them every day. However, 70% ofthe children were reported by their mothers as exposed to ETS at home. This percentage (70%) was less than the percentage (86%) of smokers who smoked at home daily. About 31.1% of the mothers reported symptoms of coughing and running nose (20.6%) in their children when they were exposed to ETS. To protect the child from ETS exposure, 43% of the mothers requested the father not to smoke near the child, 33.1% requested the father to smoke less cigarettes and 31.5% advised the father to quit smoking. 4 In conclusion, sick children in Hong Kong are at risk of exposure to ETS, but not all mothers are aware of the health risks and their actions were inadequate. There is a critical need to promote awareness of ETS exposure and the health risks in the family in Hong Kong so as to reduce illness and hospital admission in children.

Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.

This cross-sectional descriptive survey investigated determinants of malaria prevention and treatment seeking behaviours of pregnant undergraduates resident in university hostels, South-East Nigeria. Purposive sampling was used to enrol 121 accessible and consenting undergraduates with self-revealed and noticeable pregnancy residing in twenty-three female hostels of four university campuses in Enugu State, Nigeria. Structured interview guide developed based on reviewed literature and WHO-recommended malaria prevention and treatment measures was used to collect students’ self-report data on malaria preventive health behaviours, sick role behaviours, and clinic use using mixed methods. The WHO-recommended malaria prevention measures were sparingly used. Some believed that pregnancy does not play any role in a woman’s reaction to malaria infection. Only 41 (50.6%) visited a hospital for screening and treatment. Thirty-four (28.1%) used antimalaria medicine bought from chemist shop or over-the-counter medicines, while 33 (27.3%) used untreated net. The students were more likely to complete their antimalaria medicine when they were sick with malaria infection than for prevention (p=0.0186). Knowledge, academic schedule, cultural influence on perception and decision-making, and accessibility of health facility were key determinants of the women’s preventive and treatment seeking behaviours. Health education on malaria prevention and dangers of drug abuse should form part of orientation lectures for all freshmen. University health centres should be upgraded to provide basic antenatal care services.

Little is known about the correlates of physical activity and sedentary behavior in Hispanic adolescents. This study examined at baseline and 2-year follow-up: (1) the relationship between self-efficacy for physical activity and physical activity, (2) the association of weight perception with physical activity and sedentary behavior, and (3) whether sex moderated these associations. Hispanic adolescents ( N = 483 at baseline; age 15-17 years; 55.1% girls) completed questionnaires that assessed their self-efficacy for physical activity, weight perception, and time spent in physical activity and sedentary behavior. Multiple-group path analyses were conducted to examine the proposed relationships and determine whether they were moderated by sex. Models controlled for body mass index, weight loss intention, participation on a sports team, language spoken at home, parental education, and country of birth. Self-efficacy was related to time spent in physical activity in boys ( b = .35, p < .001) and girls ( b = .41, p < .001) at baseline, but not 2 years later. No association was found for weight perception and time spent in physical activity and sedentary behavior. Post hoc analyses for overweight participants at baseline showed that weight perception was associated with time spent watching television. Overall, the findings suggest that self-efficacy is an important correlate, but not a predictor, of physical activity among Hispanic adolescents. Including strategies to address and enhance self-efficacy for physical activity in lifestyle interventions may increase adherence to physical activity recommendations and help reduce the high prevalence of obesity in this population.

The article is devoted to the analysis of theoretical and practical aspects the problem of psychology, psycholinguistics and psychosemantics of health. The analysis of the approaches to study the phenomenon of health has been carried out; the psycholinguistic aspects of the problems are identified. It is demonstrated that the current state of development of psycholinguistics makes it possible to speak about the essential role of personality’s speech experience peculiarities in saving its health. The general idea that our research is devoted to is the notion that word formation of our thoughts can be consider as a signal or predictor of disease. Thus, the goal is to determine the features of speech experience, which correlate with the state of human health, the separation of qualitative differences in the speech production of healthy and sick people. The general hypothesis is that there are common narrative signs that unite people with a medical diagnosis. The purpose of this publication is to identify the differences in the construction of the psychosemantic fields of the concepts "health" and "disease" in the minds of healthy people and people with medical diagnosis. In this direction, an empirical study of the psychosemantic fields of the concepts "health" and "disease" is carried out. Comparison the results in the sample groups "Healthy", "Oncohealthy" and "Patients" made it possible to distinguish the features of perception the concepts "health" and "disease". People who are in the process of treatment, "health" is characterized as unfavorable, unhappy, hostile to the person, as well as unreliable, soft, easy to lose. "Illness" in the semantic fields of sick people "exists" as heavy, firm, active and aggressive. The disease is equally negative perceived by both healthy and sick people; however, the experience of those who overcome the disease shows a decrease in the perceptions of the strength and activity of the disease, increasing self-confidence in overcoming the disease. Comparison of the semantic fields of cancer patients and people who have overcome this disease makes it possible to conclude that settings of personality traits in the semantics, in terms of illness, are one of the factors that significantly affect the course and outcomes of treatment.

Zusammenfassung: Gesundheits-Apps werden mittlerweile von vielen Menschen alltäglich genutzt. Diese Apps zielen auf die Förderung einer gesunden Lebensweise. Ausgehend von einem weiten Verständnis von Nudging als Methode, um Menschen in erwünschte Richtungen zu lenken, ohne ihnen die Entscheidungssouveränität zu nehmen, ist Nudging bei Gesundheits-Apps omnipräsent. Im Beitrag wird auf Basis qualitativer Interviewdaten die Hypothese generiert, dass es drei verschiedene Ebenen des Nudgings bei der Anwendung von Gesundheits-Apps gibt: Erstens können Apps als Instrumente genutzt werden, um sich selbst zu einem gesundheitsbewussteren Lebensstil „anzustupsen“ (Self-Nudging). Zweitens findet Nudging durch Anbietende von Apps statt (Top-down-Nudging), zum Beispiel mithilfe von Standardeinstellungen, die eine bestimmte Nutzung nahelegen. Drittens lässt sich eine weitere Ebene des Nudgings mit Gesundheits-Apps identifizieren. So können die von den Apps generierten persönlichen Gesundheitsdaten mit den Daten anderer Nutzenden verglichen werden. Dadurch kann eine Norm gesunden Verhaltens entstehen und auf das Verhalten der Nutzenden zurückwirken (Bottom-up-Nudging). Die von uns interviewten Personen, die Apps nutzen, sehen nicht nur Vorteile in der Nutzung, sondern befürchten auch gesundheitliche Risiken. Vor diesem Hintergrund schlagen wir vor, präventiv wirkende evidenzbasierte Qualitätsstandards verbindlich einzuführen, beispielsweise in Form einer Ampelkennzeichnung. Summary: More and more people use health apps in their daily life to promote a healthy lifestyle. Starting from a wide understanding of nudging as a method to steer people in certain directions while preserving liberty of choice, nudging is omnipresent in the realm of health apps. On the basis of qualitative interview data, we generate the hypothesis, that nudging in the context of health apps takes place on three different levels: First, apps can be used as self-nudging tools and contribute to health conscious self-steering. Second, nudging is used by private companies using default settings in order to nudge users towards a certain way of use (topdown- nudging). Finally, there is an intermediate level of nudging since the personal health data generated by apps can be compared with other users. This might lead to the emergence of a health behaviour norm affecting again the user behaviour (bottom-up-nudging). The interview data shows that users see both, advantages but also health risks resulting from health app use. Against this background we suggest the compulsory introduction of preventive evidence based quality standards taking for example the form of a traffic light system.

We evaluated the associations of risk perception, self-efficacy, and trust with two health promotion behaviors (food habits and exercise) and depressive mood. Diabetic patients aged between 40 and 64 ( n = 1195) were included in the analyses. Risk perception worsened behavioral changes in terms of food habits and depression, whereas self-efficacy and trust improved food habits, exercise, and depression; trust improved exercise and depression. In conclusion, self-efficacy and trust appear to be more beneficial than risk perception for positive behavioral changes and for improving depression in diabetic patients. However, their influence on behavioral changes may be different according to the types of behaviors.