Psychological distress among Thai migrant workers in Israel

The purpose of this cross-sectional study was to examine the associations between migration stressors and psychological distress among Thai migrant agricultural workers in Israel, and to examine the direct and indirect contribution of socio-cultural variables to this relationship. Two hundred and twenty-one Thai male workers were interviewed using a structured questionnaire that included demographic variables and occupational exposures to organophosphate pesticides (as control variables), migration stressors, intervening variables (traditional health beliefs, social support, drinking behavior, and utilization of medical services), and a psychological distress scale. In multivariate analysis, migration stressors, the migrants' traditional health beliefs, quality of current social relationships, drinking behavior, as well as age and occupational exposure were significantly associated with psychological distress. Workers who reported higher migration stressors (perceived the migration to be difficult, and often felt homesick), those with higher levels of traditional health beliefs, those whose social relationships with other Thai co-workers were poor, those who consumed either no alcohol or large amounts of alcohol, and those who reported 'problem drinking' had significantly higher levels of psychological distress. A moderating effect of the quality of social relationships with co-workers on the association between homesickness and psychological distress was found. Additionally, migrants aged 28-34 and those who were experiencing eye irritation from chemicals at work had significantly increased levels of distress. The findings demonstrate the focal role of specific migration stressors and the current socio-cultural context on psychological distress of migrant workers.     

Primary care professionals' perceptions of depression in older people: a qualitative study

An understanding of patients' perspectives is crucial to improving engagement with health care services. For older people who may not wish to bother medical professionals with problems of living such as depression, such exploration becomes critical. General practitioners (GPs), nurses and counsellors working in 18 South London primary care teams were interviewed about their perceptions of depression in older people. All three professional groups shared a predominantly psychosocial model of the causes of depression. While presentation of somatic symptoms was seen as common in all age groups, identification of depression in older patients was complicated by co-existent physical illnesses. GPs reported that older patients rarely mentioned psychological difficulties, but practice nurses felt that older people were less inhibited in talking to them about "non-medical" problems. Many older people were perceived to regard symptoms of depression as a normal consequence of ageing and not to think it appropriate to mention non-physical problems in a medical consultation. Men were thought to be particularly reluctant to disclose emotional distress and were more vulnerable to severe depression and suicide. Some GPs had mixed feelings about offering medication to address what they believed to be the consequences of loneliness and social isolation. Participants thought that many older people regard depression as a "sign of weakness" and the perceived stigma of mental illness was widely recognised as a barrier to seeking help. Cultural variations in illness beliefs, especially the attribution of symptoms, were thought to profoundly influence the help-seeking behaviour of elders from minority ethnic groups. Families were identified as the main source of both support and distress; and as such their influence could be crucial to the identification and treatment of depression in older people.     

Perception of genital prolapse: a hospital-based study in Alexandria (Part II)

Genital prolapse is a common health problem, understanding women's perceptions and beliefs may illuminate our understanding of their health seeking behavior which form a first step in any effort to improve their health. The present study was designed to investigate the perception of genital prolapse among women attending the outpatient clinic in El-Shatby Maternity University Hospital in Alexandria. Data was collected from a sample of 291 women who had any form of genital prolapse. Women's knowledge about risk factors for genital prolapse, women's beliefs related to genital prolapse as well as their beliefs about assistance at delivery (beliefs were assessed through the Health Belief Model) were measured for women who knew that they were suffering of genital prolapse (n = 40). The results revealed that more than two thirds of cases (70.4%) had poor (36.4%) or fair knowledge (34%) and only 29.6% had satisfactory knowledge. The majority of women having positive perception to diagnosis and symptoms for genital prolapse had high perception of "susceptibility" to and "severity" of complications of genital prolapse (97.5% and 85% respectively). More than two thirds (67.5%) had high scores of "perceived benefits" of treatment and medical advice, while nearly one third (32.5%) scored moderate. The majority of women (82.5%) had either moderate scores (55%) or high scores (27.5%) of perceived barriers to compliance to medical instructions or recommended surgery. About two thirds of cases (65.6%) sought medical care later than one year of perception of symptoms. Women's knowledge and degree of genital prolapse were directly related to women's report of symptoms characteristic of prolapse, while the level of education was inversely related. Health education for women on different aspects of reproduction using appropriate materials is highly recommended.     

Social workers' educational needs in end-of-life care

A survey of 391 health care social workers assessed educational content and skills needed for competence in practice with those facing the end of life. Content perceived as most needed included psychological and social needs of patients and families; psychosocial interventions to ameliorate distress; and the influence of dying on family dynamics. Assessing complex needs of patients/families; communication of psychosocial needs of patient/family to team members; facilitation of effective family and team communication; and provision of crisis intervention were the skills perceived to be required for competence in end-of-life care practice. Results of these data can be used to develop model end-of-life care curricula for continuing education programs and to identify content for possible inclusion in social work programs.     

Health care professionals’ perceptions of seriously ill women

Physicians, psychologists, and nurses read one of four vignettes describing a woman who had received one of four diagnoses—breast cancer, lung cancer, heart attack, or severe burn—and indicated on the Profile of Mood States (McNair, Lorr, & Droppelman, 1971) how they perceived the woman had been feeling during the past week. They then answered 10 questions about the woman's recovery and about their own anticipated behaviors while interacting with her. A number of differences emerged between professional groups in terms of their expectations for patients regardless of diagnosis. In addition, respondents held different emotional expectations for the patient, based solely on her diagnosis. These results support the need for training health care professionals to recognize psychological distress in, and appropriately refer, seriously ill women.     

Same-Sex Behavior and Health Indicators of Sexually Experienced Filipino Young Adults

The Philippines is one of seven countries in which HIV incidence has recently increased—much of this increase has been among men who have sex with men. Despite this trend, knowledge on sexuality and same-sex behaviors in the Philippines is limited. This study examines same-sex behavior, sexual outcomes, substance use, and psychological distress among young adults participating in the 2005 Cebu Longitudinal Health and Nutrition Survey (CLHNS). We use gender-stratified, multivariate models to compare young adults who reported same-sex behaviors and those who did not. Among a cohort of 1,912 Filipino young adults (ages 20–22), 58.2 % were sexually experienced and 15.1 % of them reported same-sex sexual contacts or romantic relationships. Compared to females, more males reported same-sex sexual contact (19.4 vs. 2.3 %) or same-sex romantic relationships (9.2 vs. 4.1 %). Young adults reporting same-sex behavior had higher odds of smoking, drug use, perceived stress, and more sexual partners as compared to their peers. Males who reported same-sex behavior initiated sex earlier than those males who did not report same-sex behaviors. There were no significant differences in depressive distress. Earlier sexual initiation and higher levels of substance use among Filipino young adults engaging in same-sex behavior highlight the need to address unique health issues within this population. Mixed findings for depressive distress and perceived stress indicate that further investigation is needed to explore the potential impacts of same-sex status on mental health outcomes, particularly in lower- and middle-income countries such as the Philippines.     

Factors Related to Parenting Behavior in a Sample of Adolescent Mothers With Two-Year-Old Children

The purpose of this study was to examine factors related to the parenting behavior of adolescent mothers. A sample of 99 adolescent mothers who were in the Family TIES family support program and their 24-month-old children were included in this study; mothers in the program had been randomly assigned to one of two treatment groups before their children were born. An ecological model was used to select potential influences on parenting. Among the factors examined were: (a) characteristics of the mother (b) characteristics of the child, and (c) contextual factors. The teens' parenting behaviors were assessed with two measures: (a) the NCAST HOME, a version of the HOME inventory that can be used in a clinic setting, and (b) family advocates' ratings of parenting practices. Bivariate correlational analyses revealed that several factors were predictive of parenting behavior. Teens who provided higher quality care had more positive child-rearing beliefs, were less psychologically distressed, perceived their children as less irritable, and lived in higher quality neighborhoods. African-American teens received lower scores than other teens on the NCAST HOME and on the advocates' ratings of parenting. Multiple regression analysis showed that childrearing beliefs and ethnicity were predictive of NCAST HOME scores when other factors were controlled. Childrearing beliefs and psychological distress level were predictive of the advocates' ratings of the teen's parenting behavior in the regression analysis.     

Perceptions of disability and occupational stress as discriminators of work disability in patients with chronic pain

Pain-related work disability can be influenced by a number of medical, physical, and psychosocial factors. The present study investigated the role of perceived disability, occupational stress, pain, and distress in patients with chronic pain disorders who work despite pain and patients who are work disabled. A total of 165 patients referred to a multidisciplinary pain treatment center for chronic pain (> 6 months) were studied. The two groups were compared on age, gender, education, marital status, duration of pain problem, pain severity, psychological distress, perceived disability, and perception of the work environment. A discriminant function analysis was computed entering pain severity, distress, perceived disability (physical and psychosocial) and work environment variables. The two groups were equivalent on age, gender, education, marital status, and duration of pain problem. The groups differed on diagnosis and insurance coverage with the work-disabled group diagnosed with low back pain and receiving Workers Compensation coverage more frequently than working controls. Univariate analyses indicated that the work-disabled group reported higher pain severity, perceived physical and psychosocial disability, and job stress than their working cohorts. The discriminant function analysis indicated that the perception of physical disability, supervisor support, distress, and work pressure were capable of correctly classifying patients with chronic pain who continued to work from those who were work disabled. These findings indicate the importance of evaluating perceived disability and job stress, and if present, directing intervention effort at these factors in order to facilitate work re-entry.     

The relationship between health information sources and mental models of cancer: findings from the 2005 Health Information National Trends Survey

This study used data from the 2005 Health Information National Trends Survey, a national sample of U.S. households (N?=?5,586), to (1) explore the extent to which specific sources of health information are associated with certain beliefs about cancer; and (2) examine whether the relationship between health information sources and beliefs about cancer is moderated by psychological distress. Health information on the local news was associated with greater ambiguity about cancer prevention recommendations (OR 1.22, 95% CI 1.02-1.46, p?相似文献   

Exploration of factors affecting mammography behaviors

Of an estimated pool of 1,700 potential participants, only 382 (22%) eligible women participated in a low-cost breast cancer screening program offered to university and medical center employees. Because most women were still available and data were needed to understand why the opportunity to participate was refused by so many, a survey was done to determine factors related to mammography behavior. Three distinct groups of women were identified according to health beliefs, mammography behaviors, and modifying factors. Women who participated in the mammogram program were predominantly well-educated working women who were aware of mammography and its relationship to the breast cancer trajectory; they were affected by cost and convenience issues. One group of women did not participate in the program offered because they had had a recent mammogram; these women were at high risk for breast cancer and perceived mammography to be beneficial. The women who did not participate for other reasons were in nonprofessional jobs, had lower levels of education, and tended not to participate in the health care system as readily as women in the other groups; they perceived themselves less susceptible to breast cancer, valued mammography less, and knew less about breast cancer.     

Preferences for health care involvement, perceived control and surgical recovery: a prospective study

In a sample (N = 75) of coronary bypass patients, we examined the manner in which preoperative perceptions of personal control over recovery, desires for behavioral involvement in health care, and desires for information about health care predicted recovery in the hospital. Results indicated that preoperative control beliefs and desires for health care involvement predicted independently several important indices of recovery. Specifically, patients who prior to their surgery expressed a greater desire for information tended to experience less surgical pain and more negative psychological reactions. Greater preferences for behavioral involvement were associated with greater pain behavior, more ambulation, and shorter hospital stays. Finally, greater perceived personal control over recovery was associated with a shorter hospital stay.     

Knowledge,Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian,Gay, Bisexual,and Transgender (LGBT) Patient Health care

Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs’ knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.     

Adolescents' health beliefs are critical in their intentions to seek physician care

BACKGROUND: The examination of predictors of adolescents' intentions to use health care for different types of health issues has received little attention. This study examined adolescents' health beliefs and how they relate to intentions to seek physician care across different types of health problems. METHODS: Two hundred ten high school students (54% females; 76.6% participation rate) completed a self-administered survey of four separate age- and gender-specific health case scenarios: an adolescent who has symptoms of pneumonia; smokes five cigarettes daily; plans to initiate sex; and has symptoms of depression. For each health scenario, participants rated the seriousness of the health problem, physician effectiveness, and intentions to seek physician care. RESULTS: Most adolescents believed all health problems were serious except for planning to initiate sex (P < 0.001). Adolescents believed that physicians were most effective in diagnosis and treatment for pneumonia, followed by cigarette use, depression, and sex, respectively (P's < 0.001). Adolescents' intentions to seek physician care were greatest for physical as compared to risk behavior or mental health problems (P < 0.001). Multiple regression analyses revealed that adolescents had greater intentions to seek physician care for cigarette, sex, and depression when they believed physicians were effective and they perceived these as health problems after controlling for age and gender (all P's < 0.001). Health beliefs explained 12% to 49% of the variance in intentions to seek care (all P's < 0.001). CONCLUSIONS: Adolescents' health beliefs are important when understanding intentions to seek physician care. Health care use may be improved by increasing adolescents' beliefs that physicians are effective in areas other than physical health, including risk behaviors and mental health.     

Patients'' satisfaction with care after stroke: relation with characteristics of patients and care.

OBJECTIVES: To evaluate stroke patients' satisfaction with care received and to identify characteristics of patients and care which are associated with patients' dissatisfaction. DESIGN: Cross sectional study. SETTING: Sample of patients who participated in a multicentre study on quality of care in 23 hospitals in the Netherlands. PATIENTS: 327 non-institutionalised patients who had been in hospital six months before because of stroke. MAIN MEASURES: Data were collected on (a) characteristics of patients: socio-demographic status, cognitive function (mini mental state examination), disability (Barthel index), handicap (Rankin scale), emotional distress (emotional behavior subscale of the sickness impact profile) and health perception; (b) characteristics of care: use of various types of formal care after stroke, unmet care demands perceived by patients, unmet care demands confirmed by their general practitioners, continuity of care, and secondary prevention, and (c) patients' satisfaction with care received. RESULTS: 40% of the study sample were dissatisfied with at least one type of care received. Multivariate analyses showed that unmet care demands perceived by patients (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.8-5.7) and emotional distress (OR 1.8, 95% CI 1.1-3.0) were the main variable associated with dissatisfaction. CONCLUSIONS: Patients' satisfaction was primarily associated with emotional distress and unmet care demands perceived by patients. No association was found between patients' satisfaction on the one hand and continuity of care or secondary prevention on the other; two care characteristics that are broadly accepted by professional care givers as important indicators of quality of long term care after stroke. IMPLICATIONS: In view of these findings discussion should take place about the relative weight that should be given to patients' satisfaction as an indicator of quality of care, compared with other quality indicators such as continuity of care and technical competence. More research is needed to find which dimensions of quality care are considered the most important by stroke patients and professional care givers.     

Rural Mexican-American Adolescent Sexual Risk Behavior

CONTEXT: There is a need for community-based, culturally sensitive, cognitive-behavioral interventions to reduce sexual risk behavior among minority adolescents. Studies of adolescent risk and protective behaviors have focused on identifying modifiable psychosocial variables that predict differential outcomes for subsequent intervention efforts. Research has been scarce in studies of rural minority adolescent women. PURPOSE: To examine the protective and risk behaviors of these rural Mexican-American adolescent women and their relationship to physical or sexual abuse. METHODS: Mexican-American adolescent women aged 14-19 years were recruited through a rural health clinic and administered a self-report assessment for protective and risk behavior and sexual, physical, and psychological abuse. FINDINGS: Rural minority adolescent women endured high levels of psychological distress and many risk behaviors yet experienced few protective behaviors. Barriers to health care included access and confidentiality. Physically or sexually abused adolescents endured relatively greater risk and fewer protective behaviors than nonabused. CONCLUSIONS: Rural Mexican-American adolescent women may benefit from confidential identification and assessment of abuse history and risk and protective behaviors so that appropriate psychological treatment can accompany accessible medical treatment. The prevalence of risk behaviors and abuse among these women presents a need for development of behavioral interventions for risk reduction and promotion of health protective behaviors.     

Factors Influencing Medical Information Seeking Among African American Cancer Patients

Qualitative research methods were used to explore factors that may affect medical information seeking, treatment engagement, and emotional adjustment among African American cancer patients. Focus group findings suggest that an array of cultural and socioeconomic factors plays important roles in the behavior of African American cancer patients. Participants described a number of important barriers and facilitators of medical information seeking and treatment participation. Factors linked to the health care-related behaviors and adjustment of African American cancer patients included limited knowledge and misinformation about cancer, mistrust of the medical community, concerns about privacy, lack of insurance, religious beliefs, and emotional issues such as fear and stigma associated with seeking emotional support. Recommendations are made that may assist mental and physical health providers in improving patient information and mental and physical health outcomes of African American cancer patients.     

Perceptions and experiences of health care seeking and access to TB care--a qualitative study in rural Jiangsu Province, China

This study aims to obtain an in-depth understanding of factors that influence the health seeking behavior of TB patients, and access to tuberculosis (TB) care in counties with or without National TB Control Program (NTP) in rural China. Sixteen focus group discussions (FGDs) composed of TB patients and health care providers were held. Content analysis showed perceptions that financial difficulties influence health care-seeking behavior of TB patients in both program and non-program counties. Female and elderly patients were perceived to be more reluctant to seek health care and to seek care for cough from village health stations rather than general hospitals. Many TB patients said they could not afford the cost of TB care, even where services were subsidized. Fee-for-service incentives of health care providers and their ability to make a correct TB diagnosis were also perceived to influence patient access to TB care. Inappropriate treatment of cough patients was perceived to increase the risk of missing smear-positive diagnoses.     

Factors influencing medical information seeking among African American cancer patients

Qualitative research methods were used to explore factors that may affect medical information seeking, treatment engagement, and emotional adjustment among African American cancer patients. Focus group findings suggest that an array of cultural and socioeconomic factors plays important roles in the behavior of African American cancer patients. Participants described a number of important barriers and facilitators of medical information seeking and treatment participation. Factors linked to the health care-related behaviors and adjustment of African American cancer patients included limited knowledge and misinformation about cancer, mistrust of the medical community, concerns about privacy, lack of insurance, religious beliefs, and emotional issues such as fear and stigma associated with seeking emotional support. Recommendations are made that may assist mental and physical health providers in improving patient information and mental and physical health outcomes of African American cancer patients.