Paradoxical health care utilization patterns among children in Korea who did not receive mandatory pneumococcal vaccination

BackgroundUnvaccinated children in the National Immunization Program (NIP) are a public health concern. We used Korean national population data to analyze health care utilization patterns of NIP-eligible children and identify the unvaccinated group.MethodsPneumococcal vaccination (PCV) records were reviewed to determine the vaccination status of children born between 2013 and 2015. Children who received three doses or more from a 3 + 1 schedule were defined as vaccinated, while those who had not received any pneumococcal vaccinations were defined as unvaccinated. Corresponding health care utilization records were retrieved from the National Health Insurance Review and Assessment Service. The incidence of combined pneumococcal infections and health care utilization rates were estimated and the proportion of complementary and alternative medicine (CAM) utilization among the total health care utilization records was measured.ResultsIn total, 26,893 (2.1%) of 1,272,685 children remained unvaccinated. The incidence of pneumococcal infection was lower in unvaccinated children, at 10.1 cases (9.8–10.3) per 1000 person-months. However, their health care utilization was significantly lower than that noted for vaccinated children (hospital visit rate: 26.6 (95% confidence interval [CI] 26.5–26.7) vs. 3.2 (3.2–3.3) visits annually), indicating underdetection. CAM treatment was sought at least three times often more in unvaccinated children than in vaccinated children (3.5% vs. 1.1%).ConclusionUnvaccinated children showed significantly lower utilization of overall health care than the vaccinated children; however, a higher preference for CAM was noted among unvaccinated children than among vaccinated children. These differences in care-seeking patterns should be considered when identifying unvaccinated children and providing protection through vaccination programs.     

Social networks among elderly women: implications for health education practice

The general aim of the present study was to examine and help clarify the properties of the distinctions between social networks and social support, their relationship to health status, and their implications for health education practice. More specifically, a secondary data analysis was conducted with 130 white women, community residents, between the ages of 60 and 68, which examined the relationship between psychological well-being and social network characteristics. These characteristics are categorized along three broad dimensions: structure--links in the overall network (size and density); interaction--nature of the linkages themselves (frequency, homogeneity, content, reciprocity, intensity, and dispersion); and functions which networks provide (affective support and instrumental support). A combination was made and relative strength investigated of several network characteristics representative of the quality of interactions (i.e., reciprocal affective support, intensity, and affective support) and those representing the quantity of interactions (i.e., size, density, and frequency).     

Mortality and failure among tuberculosis patients who did not complete treatment in Vietnam: a cohort study

Background  

Tuberculosis treatment failure and death rates are low in the Western Pacific Region, including Vietnam. However, failure or death may also occur among patients who did not complete treatment, i.e. reported as default or transfer-out. We aimed to assess the proportion failures and deaths among new smear-positive pulmonary tuberculosis patients with reported default or transfer-out.     

Changes in primary health care policy: the implications for joint commissioning with social services

Both the primary health care team (PHCT) and social services departments in the UK have undergone substantial changes to their organization and function since 1990. This paper looks at developments in primary health care policy that have affected the relationships between them regarding the commissioning of health and social care services. It focuses on evidence from seven initiatives designed to involve members of the PHCT in commissioning social care services. It examines some of the benefits and challenges of working together to commission services for health authority managers, GPs, district nurses, care managers and social work team managers in the light of impending changes to the PHCT, particularly the abolition of fundholding and the introduction of Primary Care Groups.     

Utilization of maternal health care services among indigenous women in Bangladesh: A study on the Mru tribe

Despite startling developments in maternal health care services, use of these services has been disproportionately distributed among different minority groups in Bangladesh. This study aimed to explore the factors associated with the use of these services among the Mru indigenous women in Bangladesh. A total of 374 currently married Mru women were interviewed using convenience sampling from three administrative sub-districts of the Bandarban district from June to August of 2009. Associations were assessed using Chi-square tests, and a binary logistic regression model was employed to explore factors associated with the use of maternal health care services. Among the women surveyed, 30% had ever visited maternal health care services in the Mru community, a very low proportion compared with mainstream society. Multivariable logistic regression analyses revealed that place of residence, religion, school attendance, place of service provided, distance to the service center, and exposure to mass media were factors significantly associated with the use of maternal health care services among Mru women. Considering indigenous socio-cultural beliefs and practices, comprehensive community-based outreach health programs are recommended in the community with a special emphasis on awareness through maternal health education and training packages for the Mru adolescents.     

流动人口孕产妇健康教育社区管理的探索与实践

当前,我国流动人口规模达到历史新高,2011年流动人口总量已接近2.3亿,占全国总人口的17%。＂80后＂新生代农民工已占劳动年龄流动人口的近一半。监测数据显示,新生代农民工婚前怀孕的比例占42.7%[1]。健康教育是通过信息传播和行为干预,帮助个人和群体掌握保健知识,树立健康观念,自愿采纳健康行为的教育活动[2]。     

同伴教育在农村孕产妇健康促进中的应用

受多种条件的制约,农村地区的孕产期保健比较落后,传统的健康教育方式在农村孕产妇健康促进中存在局限性:①专业人员健康教育的影响是有限的;②农民文化水平低,对知识的正确理解性差;③对农村孕产妇的健康作用不持久;④耗费大量的人力、物力;⑤容易流于形式.而同伴教育得到多种社会学和心理学理论支持,在艾滋病的预防、青少年物质滥用等方面都取得很好的收效.同伴教育具有文化适宜性、可接受性、经济性、科学性的优点,应用到农村孕产妇保健从理论上是可行的,需要做社区对照试验来检验.     

Health literacy: a policy challenge for advancing high-quality health care

Health literacy, at the intersection of health and education, involves more than reading ability. Studies of health literacy abilities show that many Americans with the greatest health care needs have the least ability to comprehend information required to navigate and function in the U.S. health care system. This paper defines health literacy as an important policy issue and offers strategies for creating a health-literate America.     

阳江市1230例孕产妇的孕产期保健状况调查

目的 了解阳江市1230例孕产妇的孕产期保健现状,为提高孕产期保健质量提供依据.方法 采用分层整群随机抽样方法,对阳江市3个县(区)1230例孕产妇的基本情况,孕期保健知识及服务状况、妊娠分娩期健康状况等4个方面进行人户问卷横断面调查,并对结果进行统计分析.结果 本次研究有效问卷1220份,产妇对孕产期保健知识总体知晓...     

上海市孕妇对孕产期保健的认知行为现状及影响因素分析

目的:了解上海市嘉定区孕妇对于孕产期保健的知识、态度和行为状况,以及影响它们的因素,为探索孕产期保健干预策略研究提供依据。方法:借鉴健康教育的"知信行"理论,自行设计调查问卷,对上海市嘉定区4个社区的产妇进行了孕产期保健现状调查,采用多重线性回归统计分析产妇保健的影响因素,SPSS 13.0进行统计分析。结果:知晓率在90%以上,但对产后方面知识的知晓率相对较低。与到达医疗点时间、职业、家庭月收入相关;态度认知程度达到95%,与丈夫的文化程度相关;行为发生率为78.4%,与月收入、户口所在地相关。结论:需要加强孕产期健康教育的全程性和社会支持,增强对农村地区保健服务的可及性。     

Health care for children: perspectives for community health services

The study aims at analysing the community health nursing practice in the care of children and to point out the perspectives for the coming millennium. The study was conducted by review of the literature. It provides a brief synthesis of the current social context and a short historic reflection about health practices with children and community health nursing practice. It is observed that the practice of nursing is conducted according to the official Health Assistance Program for Children. Despite its goals, however, the program has not been efficient. In this way it will be valued the multiprofessional work in the accompaniment of the growth and development, domiciliary visit, and "groups of mothers" in which the nurse will be a co-participant of the staff, with the great contribution that health professionals with preventions and promotions background frequently offer.     

上海市孕妇弓形虫病健康教育需求调查

目的了解孕妇对弓形虫病相关知识和健康教育方式的需求情况,为开展防治弓形虫病健康教育提供依据。方法在上海市5个区12家医疗机构随机抽取接受产前检查的1103名建卡孕妇为调查对象,进行孕妇弓形虫病的相关知识和健康教育方式需求情况的问卷调查。结果有22．8％的孕妇曾主动寻求过有关弓形虫病的知识,孕妇对本病的预防措施、传播途径、孕妇筛查意义和治疗对策的需求率依次为80．87％、65．82％、60．29％和46．51％,不同户籍、文化程度、职业的孕妇对健康教育的需求率存在统计学差异。对健康教育方式的需求,首选为小册子（74．25％）,其次为放映录像带（64．46％）及到专业机构咨询（40．07％）,并愿意与除家庭以外的朋友、同事或亲戚等分享知识。结论孕妇对弓形虫健康教育有需求,但不同背景人员对健康知识需求的内容和方式不同。应针对孕妇的需求采取相应的健康教育。     

孕妇母婴健康素养与产前抑郁的关系:家庭功能的中介作用

目的 探讨孕妇母婴健康素养与产前抑郁的关系及家庭功能在母婴健康素养水平与产前抑郁间的中介作用。方法 采用单纯随机抽样的方法抽取贵阳市妇幼保健院孕产保健科产检的1 493名孕妇作为研究对象;采用一般情况调查问卷、患者健康问卷抑郁量表、家庭关怀度指数问卷和母婴健康素养测评问卷进行问卷调查;利用Bootstrap中介效应检验法检验各变量间的效应关系,运用AMOS建立结构方程模型。 结果 本研究孕妇产前抑郁情绪检出率为46.1%,孕妇产前抑郁评分为(5±4.55)分,家庭功能评分为(6.85±2.84)分,母婴健康素养评分为(40.97±15.70)分;产前抑郁与母婴健康素养(r=-0.147)、家庭功能(r=-0.251)呈负相关,母婴健康素养与家庭功能(r=0.222)呈正相关(均P<0.05);孕妇母婴健康素养对产前抑郁的直接效应为-0.084,占总效应的71.19%,家庭功能在母婴健康素养与产前抑郁间起部分中介作用,中介效应值为-0.034,占总效应的28.81%。 结论 孕妇的母婴健康素养可反向预测产前抑郁,家庭功能在母婴健康素养与产前抑郁间起部分中介作用。母婴保健人员可通过提高孕妇的母婴健康素养水平,增强孕妇的家庭功能,降低产前抑郁情绪的发生。     

流动孕妇人群艾滋病健康教育及效果评价

目的　了解流动孕妇人群在“预防与控制艾滋病母婴传播项目”中开展健康教育的可行性和效果评价。方法　随机选择项目中建卡登记的流动孕妇85人,按预定的干预措施开展健康教育,并对干预效果进行评价。结果　流动孕妇人群健康教育后艾滋病相关知识和认知应答正确率较教育前有明显提高(P <0. 0 0 1)。结论　流动孕妇人群开展预防与控制艾滋病母婴传播项目健康教育是可行和有效的     

Perinatal care for women who are addicted: implications for empowerment

This article explores societal responses to perinatal drug abuse, including stigmatic attitudes and behaviors of health care workers that are directed toward women who abuse drugs during pregnancy. Health care providers' stigmatic responses can deter women from receiving perinatal care and place women and their unborn children at risk. Because poor women and women of color face a greater probability of being prosecuted or losing custody of their children for using drugs while they are pregnant, the article emphasizes societal responses to these client populations. Empowering strategies are suggested by which social workers and clients can potentially redefine perinatal drug abuse as a health problem rather than a legal issue and improve the environment in which perinatal care is provided.