Kim, So-Young;Cho, In-Sook;Lee, Jae-Ho;Kim, Ji-Hyun;Lee, Eun-Jung;Park, Jong-Hyock;Lee, Jin-Seok;Kim, Yoon
Journal of Preventive Medicine and Public Health
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v.40
no.6
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pp.487-494
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2007
Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.
Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.
Asiedu, Gladys B;Breitkopf, Carmen Radecki;Kremers, Walter K;Ngo, Quang V;Nguyen, Nguyen V;Barenberg, Benjamin J;Tran, Vinh D;Dinh, Tri A
Asian Pacific Journal of Cancer Prevention
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v.16
no.12
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pp.4895-4900
/
2015
Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of $34{\pm}11.9$ years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention.
Objectives : To estimate the awareness, treatment and control rate, as well as to identify the awareness-related factors for hypertension. Methods : The study participants were 482 adults (men 206, women 276), aged 45 or over, diagnosed with hypertension and living in Chuncheon. The awareness rate was defined as the proportion of persons among those with hypertension who had previously been diagnosed by a physician. The treatment rate was defined as the proportion of persons who had used anti-hypertensive medication, among those who were aware of their hypertension. The control rate was defined as the proportion of persons who kept blood pressure normal, among those who had been treated for their hypertension. Multivariable logistic regression analysis was carried out for the awareness-related factors using SAS VER 8.1. Results : The awareness, treatment, and control rate were 55,8% (53.4% for men; 57.6% for women), 89.6% (87,2% for men; 91.2% for women), and 34.4% (28.1 % for men; 38.6% for women), respectively. The awareness-related factors included a family history of hypertension (odds ratio[OR], 5.63; 95% confidence interval[95% CI]=1.53-20.72), smoking([Ex; OR 0.38, 95% CI= 0.15-0.96)], [Current; OR 0.28, 95% CI=0.10-0.80]), and alcohol intake ([Ex; OR 3.22, 95% CI 1.03-10.09],[Current; OR 3.36, 95% CI=1.30-8.71]) for men, and education(OR 2.23, 95% CI=1.10-4.53), body mass index(OR 2.72, 95% CI=1.13-6.53), and self-rated health(OR 2.38, 95% CI=1.07-5.30) for women. Conclusions : The awareness rate of hypertension among the middle aged and elderly in Chuncheon was 55.8%. The related factors of awareness were gender specific. Further studies are needed to elucidate the putative reasons for these gender differences.
Background: Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. Materials and Methods: A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. Results: Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. Conclusions: Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.
Journal of the Korea Society of Computer and Information
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v.19
no.6
/
pp.119-128
/
2014
In this study, the social welfare field training course there is a growing awareness as professionals in order to verify the impact was conducted. G-local four-year university study social work majors by sampling 198 people were examined for the purpose, through self - survey was conducted. Materials and analytical methods in order to identify the characteristics of a variable frequency, and technical analysis, T-test, F-test, ANOVA, correlation (correlation), Regression (regression) was used for the SPSS 14.0. The results are as follows. First, the personal factors of the individual physician trainees reflect (${\beta}=.197$), and then the same about Social Welfare satisfaction (${\beta}=.205$) of the Social Welfare majors had significant impact on career identity. Second, the personal factors they chose what to major in social work satisfaction (${\beta}=-.291$), and if you feel you select a parent with a major in Social Work and Social Welfare major students feel the satisfaction of having a significant effect on the level of career decision crazy. Third, individual reflect personal physician factors (${\beta}=.156$) is significantly influenced the behavior of career preparation.
The purpose of this study was to provide basic data for the development of medicinal herbs, which are useful for the treatment of chronic diseases and physical characteristics of the elderly. A total of 151 adult women aged 65 years or older currently living in Daejeon were enrolled. The contents of this study were parents' health status, recognition of the necessity for a dietary therapy, awareness of medicinal herbs, requirements for medicinal herbs, physician of medicinal herbs and obstacles to medicinal herbs. Based on these results, the differences in the perception of medicinal herbs according to the dietary needs group as well as differences in the perception of medicinal herbs according to medicinal herbicidal groups were analyzed. Of the 151 subjects, 90.7% were married, and 44.4% of them were aged between 40 and 49. Most of the patients were aged in their 70s (68.9%), and 79.5% of had chronic illnesses such as high blood pressure, hyperlipidemia, arteriosclerosis, and heart disease. It is recognized that dietary therapy is necessary for the treatment of diseases, and awareness of medicinal herbs is low but necessary. As for the requirements for medicinal herbs, the most favored was 'porridge for the prevention and treatment of diseases', and 72.2% of medicinal herbs were physicians. However, problems cited were availabitity of ingredients, cooking technique, price of ingredients, and others. In addition, both groups requiring dietary therapy and having high awareness of medicinal herbs felt that medicinal herbs would be helpful in treating diseases. Therefore, it is necessary to provide a simple medicinal herb recipe for each disease and to develop anti cooked medicinal herbs.
Norwati, Daud;Harmy, Mohamed Yusoff;Norhayati, Mohd Noor;Amry, Abdul
Rahim
Asian Pacific Journal of Cancer Prevention
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v.15
no.6
/
pp.2901-2904
/
2014
The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.
Purpose: Core competencies for becoming a good physician have been the focus of recent discussion. Understanding students' state of mind should be included in this analysis. Thus, the purpose of this study was to review recent research papers on subjective well-being in medical education and propose some suggestions. Methods: A selective search was conducted of the literature that has been published since 2000 in the Medline, Riss4U, ERIC, and KoreaMed databases using the search terms "happiness", "subjective well-being", "satisfaction", and "stress". Thirty seven studies were included in this review. Each was categorized according to 3 subjects (satisfaction, positive affect, negative affect). Results: Most studies showed relatively high levels of distress in medical students, which was related to academic worries. Although medical students were under a great deal of distress, they regarded help-seeking behavior for their distress as weakness or something negative. Conclusion: To decrease medical students' distress and sustain their well-being, there should be a change in students' awareness through curriculum, teaching methods, and coping strategies in medical education.
Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.
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