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1.
Unmet Family Planning Need: Differences and Levels of Agreement Between Husband-Wife, Haryana, India
Research question:
Is there agreement between husbands and wives regarding unmet need of family planning?Hypothesis:
The unmet need of family planning is perceived more by women then their husbands.Objective:
1) To ascertain the unmet needs of family planning for husbands and wives. 2) To ascertain the level of agreement between husbands and wives regarding unmet needs of family planning.Design:
A cross-sectional surveySetting:
Dayalpur village in Intensive field practice area of Comprehensive Rural Health Services project (CRHSP), Ballabgarh, Haryana.Study Period:
July 2003- June 2005.Participants
included 200 married couples selected by simple random sampling.Statistical Analysis:
Level of agreement between husbands and wives was analyzed using Kappa statistics.Results:
Unmet need for family planning was 11% (22 out of 200) for husbands and 17.5% (35 out of 200) for wives. The difference was seen both in unmet need for spacing (M-3.5% vs. F-6%) as well as limiting family size (M-7.5% vs. F-11.5%). Overall, 93.5% concordance was observed amongst husbands and wives. In all the cases where disagreement was seen (6.5%), wives reported having unmet need for contraception whereas their husbands perceived none. The unadjusted Kappa statistic was 0.73 and prevalence adjusted Kappa was 0.88.Conclusion:
Unmet need for family planning was significantly higher for wives compared to husbands. Despite high degrees of agreement amongst the couples, the nature of disconcordance reinforces the need for policy makers to take into account the perspective of men. 相似文献2.
Objective:
To ascertain the response of husbands to their wives'' health problems.Materials and Methods:
We selected 100 couples through a systematic random sampling from 4 purposively selected villages; these couples were interviewed by a social worker in rural North India through house-to-house survey. The role of husbands during pregnancy, puerperium and during the wives'' illness was explored. Their awareness with regard to the reproductive health problems of their wives was also ascertained. Another outpatient department (OPD)-based interview of female (n = 300) patients was conducted; 50 each at health post, subcenter, primary health centers (PHC), community health center (CHC), 50-bed hospital and apex institution. Previous consultation history was also obtained.Results:
Husbands escorted their wives to hospital in 30–40% cases. This was mainly for a visit to bigger hospitals in cities/towns. Husbands decided regarding the treatment agency in the majority of cases. In 10% cases, they took time off their work during wives'' sickness and helped in household work. Consultation within a week was 100%. The husbands'' knowledge regarding the safe period was inadequate. Majority (78%) said that women remained ill more often. Most wives were satisfied with the role of their husbands during their pregnancy or illness. A majority (80%) of husbands favored education of women up to the 10th standard and 87% were in favor of working women.Conclusion:
Reasonably favorable attitude of husbands towards their wives'' health problems was witnessed. This needs to the carefully nurtured. 相似文献3.
Badrinarayan Mishra SC Mehta Nidhi Dinesh Sinha Sushil Kumar Shukla Nadeem Ahmed Abhishek Kawatra 《Indian Journal of Community Medicine》2011,36(1):39-44
Background:
Healthcare providers being over-worked and under staffed are prone to poor mental health. Unhealthy work place compounds it further.Aims:
This study was aimed at to assess the mental health status of a medical university employee with special reference to work place stressors.Settings and design:
A cross-sectional study was designed and carried out at a Rural Health University.Materials and Methods:
Both the General Health Questionnaire (GHQ)-12 and Holmes–Rahe Scale were used to evaluate 406 participants.Statistical analysis:
Multivariate analysis, correlation, and ANOVA by SPSS 11.0.Results:
The minimum age of the participant was 19 years and the maximum 64 years, with an average age at 35.09 years. On the GHQ scale 239(58.9%) recorded psychiatric morbidity out of which 201(49.5%) had moderate and 38(9.3%) severe morbidity. Doctors were the highest stressed group (P ≤ 0.04). Prominent work environmental stressors were poor departmental reorganization, lack of cohesiveness in department, difficult superiors and juniors (P ≤ 0.001, Pearson correlation). Stressors associated with work organization and work nature were: noninvolvement in departmental decision making and lack of proper feedback; along with; work load, lack of clarity in job, and a erratic work schedule (P ≤ 0.001 on Pearson correlation). Harassment, favoritism, discrimination, and lack of self-expression (P ≤ 0.003) were other factors responsible for work dissatisfaction.Conclusions:
A high stress level was detected in the study population. The principal stressors were work environment related. Poor work culture was found to lead to job dissatisfaction among majority. 相似文献4.
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Rajni Gupta Jugal Kishore Yogesh Bansal MK Daga RC Jiloha Rajeev Singal GK Ingle 《Indian Journal of Community Medicine》2011,36(3):182-186
Objective:
To investigate the relationship of psychosocial factors (lack of social support, stress and subjective well-being) and personality traits with myocardial infarction (MI).Materials and Methods:
A case–control study involving 100 cases and 100 matched controls was conducted in Lok Nayak Hospital, New Delhi.Results:
Stress over 1 year was significantly higher in cases (P < 0.001). However, difference was not significant when scores of social support (P = 0.2), Presumptive Stressful Life Event (PSLE) over lifetime (P = 0.058) and subjective well-being (P = 0.987) were compared. MI was significantly associated with hyperactive (P < 0.001), dominant (P = 0.03), egoistic (P < 0.001) and introvert (P < 0.001) personalities.Conclusion:
Certain personality traits and recent stress may be important risk factors of MI, especially in Indians. The finding may have implications on the preventive strategies planned for MI patients. 相似文献7.
Jennifer L. Wolff PhD Marla L. Clayman PhD Peter Rabins MD Mary Ann Cook PhD Debra L. Roter DrPH 《Health expectations》2015,18(2):188-198
Background
Older adults are commonly accompanied to routine medical visits. Whether and how family companion behaviours relate to visit processes is poorly understood.Objective
To examine family companion behaviours in relation to older adults'' medical visit processes.Design and participants
Observational study of 78 accompanied primary care patients ages 65 and older.Main outcome measures
Medical visit communication (coded using RIAS), patient verbal activity (as a proportion of visit statements) and visit duration (in min), from audio recordings.Results
Companions'' facilitation of patient involvement was associated with greater patient question asking (P = 0.017) and orienting statements, less passive agreement (P = 0.004) and social talk (P = 0.013) and visits that were 3.4 min longer (P = 0.025). Facilitation of patient understanding was associated with less physician question asking (P = 0.004), visits that were 3.0 min longer (P = 0.031), and lower patient verbal activity (30.3% vs. 36.9% of visit statements; P = 0.028). Facilitation of doctor understanding was associated with greater patient biomedical information giving (P = 0.049). Autonomy detracting behaviours were not associated with visit duration but were associated with lower levels of patient verbal activity (36.3% vs. 29.1% of visit statements; P = 0.041). When companions assumed more behaviours, medical visits were incrementally longer (16.1, 19.5, 21.7 min, corresponding to 0–1, 2–4 and 5+ behaviours; P < 0.001 both contrasts), and patients were less verbally active (35.6%, 33.9%, 27.1% of visit statements; P = 0.09 and P = 0.009, respectively).Discussion
Behaviours assumed by patients'' companions were associated with visit communication, patient verbal activity and visit duration.Conclusions
Interventions to capitalize on family companions'' presence may benefit medical visit processes. 相似文献8.
Peter O Ogunjuyigbe Ebenezer O Ojofeitimi Ayotunde Liasu 《Indian Journal of Community Medicine》2009,34(2):112-116
Objective:
This paper highlights the relevance of spousal communication on males'' attitude towards their partners'' contraceptive use.Design:
This was a cross-sectional study.Materials and Methods:
Data for the study were obtained from a survey carried out in three states, Oyo, Osun, and Ondo, mainly inhabited by the Yorubas.Results:
The results show that men have a significant role to play in the adoption of contraception. About 37% of the respondents reported joint decision making on when to have another child, 40.8% on whether to stop having children, and 44% on what to do to stop childbearing. Communication between a husband and wife on reproductive matters was also recognized as a factor that may influence male participation in family planning.Conclusion:
This study has shown that the male partner may be highly motivated to obtain contraceptives. The results therefore suggest that male involvement in family planning should be encouraged through inter-spousal communication. 相似文献9.
Harkonmäki K Rahkonen O Martikainen P Silventoinen K Lahelma E 《Occupational and environmental medicine》2006,63(8):558-563
Objective
To examine the associations of mental health functioning (SF‐36) and work and family related psychosocial factors with intentions to retire early.Methods
Cross sectional survey data (n = 5037) from the Helsinki Health Study occupational cohort in 2001 and 2002 were used. Intentions to retire early were inquired with a question: “Have you considered retiring before normal retirement age?” Mental health functioning was measured by the Short Form 36 (SF‐36) mental component summary (MCS). Work and family related psychosocial factors included job demands and job control, procedural and relational justice, conflicts between work and family, and social network size. Multinomial regression models were used to analyse the data.Results
Poor mental health functioning, unfavourable psychosocial working conditions, and conflicts between work and family were individually related to intentions to retire early. After adjustments for all work and family related factors the odds ratio for low mental health functioning was halved (from OR = 6.05 to 3.67), but nevertheless the association between poor mental health functioning and strong intentions to retire early remained strong.Conclusions
These findings highlight not only the importance of low mental health and unfavourable working conditions but also the simultaneous impact of conflicts between work and family to employees'' intentions to retire early. 相似文献10.
Seo Yeon Lee Seong Ah Ha Jung Sook Seo Cheong Min Sohn Hae Ryun Park Kyung Won Kim 《Nutrition Research And Practice》2014,8(6):679-687
BACKGROUND/OBJECTIVES
Recently, there has been an increased interest in the importance of family meals on children''s health and nutrition. This study aims to examine if the eating habits and eating behaviors of children are different according to the frequency of family dinners.SUBJECTS/METHODS
The subjects were third-grade students from 70 elementary schools in 17 cities nationwide. A two-stage stratified cluster sampling was employed. The survey questionnaire was composed of items that examined the general characteristics, family meals, eating habits, eating behaviors, and environmental influence on children''s eating. The subjects responded to a self-reported questionnaire. Excluding the incomplete responses, the data (n = 3,435) were analyzed using χ2-test or t-test.RESULTS
The group that had more frequent family dinners (≥ 5 days/week, 63.4%), compared to those that had less (≤ 4 days/week, 36.6%), showed better eating habits, such as eating meals regularly, performing desirable behaviors during meals, having breakfast frequently, having breakfast with family members (P < 0.001), and not eating only what he or she likes (P < 0.05). Those who had more frequent family dinners also consumed healthy foods with more frequency, including protein foods, dairy products, grains, vegetables, seaweeds (P < 0.001), and fruits (P < 0.01). However, unhealthy eating behaviors (e.g., eating fatty foods, salty foods, sweets, etc.) were not significantly different by the frequency of family dinners.CONCLUSIONS
Having dinner frequently with family members was associated with more desirable eating habits and with healthy eating behaviors in young children. Thus nutrition education might be planned to promote family dinners, by emphasizing the benefits of having family meals on children''s health and nutrition and making more opportunities for family meals. 相似文献11.
Badrinarayan Mishra Nidhi D Sinha SK Sukhla AK Sinha 《Indian Journal of Community Medicine》2010,35(1):115-121
Background:
Road Traffic Accident (RTA) is one among the top five causes of morbidity and mortality in South-East Asian countries.(1) Its socioeconomic repercussions are a matter of great concern. Efficient addressing of the issue requires quality information on different causative factors.Research Question:
What are different epidemiological determinants of RTA in western Nepal?Objective:
To examine the factors associated with RTA.Study Design:
Prospective observational.Setting:
Study was performed in a tertiary healthcare delivery institute in western Nepal.Participants:
360 victims of RTA who reported to Manipal Teaching hospital in one year.Study Variables:
Demographic, human, vehicular, environmental and time factors. Statistical analysis: Percentages, linear and logarithmic trend and Chi-square.Results:
Most of the victims i.e. 147 (40.83%) were young (15 to 30 years); from low i.e. 114 (31.66%) and mid i.e. 198 (55%) income families and were passengers i.e. 153 (42.50%) and pedestrians i.e. 105 (29.16%). Sever accidents leading to fatal outcome were associated with personal problems (P<0.01, χ2 - 8.03), recent or on-day conflicts (P<0.001, χ2 - 18.88) and some evidence of alcohol consumptions (P<0.001, χ2 - 30.25). Increased prevalence of RTA was also noticed at beginning i.e. 198 (55%) and end i.e. 69 (19.16%) of journey; in rainy and cloudy conditions (269 i.e. 74.72%) and in evening hours (3 to 7 p.m. 159 i.e. 44.16%). Out of 246 vehicles involved; 162 (65.85%) were old and ill maintained. The contributions of old vehicle to fatal injuries were 33 (50%). Head injury was found in 156 (43.33 %) cases and its associated case fatality rate was 90.90%. In spite of a good percentage receiving first aid i.e. 213 (59.16%) after RTA; there was a notable delay (174 i.e. 48.33% admitted after 6 h) in shifting the cases to the hospitals. The estimated total days lost due to hospital stay was 4620 with an average of 12.83 days per each case.Conclusion:
Most of the factors responsible for RTA and its fatal consequences are preventable. A comprehensive multipronged approach can mitigate most of them. 相似文献12.
13.
Pikee Saxena Swati Tyagi Anupam Prakash Aruna Nigam Shubha Sagar Trivedi 《Indian Journal of Community Medicine》2011,36(2):120-123
Background:
Women with gestational diabetes mellitus (GDM) pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life.Objectives:
The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies.Materials and Methods:
This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies.Results:
Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all). Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001) among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05) in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero.Conclusion:
Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients. 相似文献14.
Bratati Banerjee GK Pandey Debashis Dutt Bhaswati Sengupta Maitrayei Mondal Sila Deb 《Indian Journal of Community Medicine》2009,34(3):227-231
Background:
Early marriage and confinement are contributing factors to high maternal and perinatal mortality and morbidity.Objective:
To assess the magnitude of the problem of teenage pregnancy and its complications.Materials and Methods:
A hospital-based cohort study was undertaken over 4 months among women admitted to a rural hospital in West Bengal. The study cohort comprised of teenage mothers between 15-19 years old and a control cohort of mothers between 20-24 years old. Data included demographic variables, available medical records, and complications viz. anemia, preterm delivery, and low birth weight. Anemia was defined as a hemoglobin level below 10 gm% during the last trimester of pregnancy, preterm delivery was defined as occurring within 37 weeks of gestation, and low birth weight was defined as babies weighing less than 2500 grams at birth.Result:
Teenage pregnancy comprised 24.17% of total pregnancies occurring in the hospital during the study period. The study group had 58 subjects and the control group had 91 subjects. The prevalence of anemia was significantly higher (P<0.05) in the women in the teenage group (62.96%) than in the women in the control group (43.59%). However, severe anemia with a hemoglobin level below 8 gm% was only found in the control group. Preterm delivery occurred significantly more (P<0.001) in the study group (51.72%) than in the control group (25.88%). The incidence of low birth weight was significantly higher (P<0.0001) among the group of teenagers (65.52%) than among the women in the control group (26.37%). Not a single newborn was above 3 kg in the study group, while none were below 1.5 kg in the control group. The mean birth weight was 2.36 kg in the study group and 2.74 kg in the control group; the difference was strongly significant (P<0.001).Conclusion:
The study shows that anemia, preterm delivery, and low birth weight were more prevalent among teenagers than among women who were 20-24 years old. This indicates the need for enhancing family welfare measures to delay the age at first pregnancy, thereby reducing the multiple complications that may occur in the young mother and her newborn baby. 相似文献15.
Sedigheh Forouhari Marjan Khajehei Marziyeh Moattari Mitra Mohit Mozhgan Safari Rad Haleh Ghaem 《Indian Journal of Community Medicine》2010,35(1):109-114
Objectives:
Women are one of the most important parts of the family and society, and community health is dependent on provision of the needs of this group. Menopause is one of the most critical stages of life among women. One of the aims of health services for all of the people in the 21st century is improvement of the quality-of-life. In menopausal women, the term quality-of-life incorporates its physical symptoms such as hot flushes, night sweats and vaginal mucosa dryness. We set out this study in order to evaluate the effect of education on the quality-of-life and the improvement of health standards in menopausal women.Materials and Methods:
Sixty-two women aged 44–55 referring to and academic outpatient clinic in Shiraz were selected by simple random sampling, and allocated in two groups. Data was collected using a modified Hildich questionnaire on quality-of-life in menopause stage. Quality-of-life of the subjects (vasomotor, psychosocial, physical and sexual aspects) were evaluated prior to and 3 months after educational intervention.Results:
Mean quality-of-life score in study and control groups, prior to education, was 81.7 and 74.8; changing to 75.3 and 75.8, respectively three months after intervention. The study group showed a significant improvement in their quality-of-life (P = 0.001). A significant difference was seen between groups in terms of changing quality-of-life after intervention (P = 0.001).Conclusions:
Appropriate training to menopausal women improves their quality-of-life and promotes their health. 相似文献16.
Background:
Dyslipidemia is a marker for ischemic heart disease (IHD), which can be detected in early childhood and tracks to adulthood. Dyslipidemia, along with factors like diet, obesity and sedentary activity, increases the risk of a child developing IHD in adulthood. Early detection and modification of these risk factors can prevent IHD.Objectives:
To study the lipid profile in children born to parents with history of premature IHD and also to study the effect of diet, lifestyle factors, and obesity in the study group.Materials and Methods:
Fifty children of parents with premature IHD and 50 control children without any family history of IHD were analyzed for cardiovascular risk factors such as lipid profile, body mass index (BMI) and hypertension. The effects of modifiable risk factors like diet and physical activity on lipid profile were analyzed. The correlation between parent and child lipid profile was studied.Results:
Mean total cholesterol, low density lipoprotein cholesterol and triglycerides were significantly higher (P<0.05) in children with family history of IHD as compared to children without family history. There was a positive correlation between lipid levels of parents and their children. Children with elevated BMI, a sedentary lifestyle, and excess oily/junk diet intake showed increased incidence of dyslipidemia (P<0.05).Conclusions:
Children of IHD patients have significant incidence of dyslipidemia. The risk factors like BMI, diet and physical activity increase the incidence of dyslipidemia. Therefore, all children of premature IHD patients should be screened for dyslipidemia. 相似文献17.
Mascie-Taylor CG Marks MK Goto R Islam R 《Bulletin of the World Health Organization》2010,88(11):854-860
Objective
To determine whether a cash-for-work programme during the annual food insecurity period in Bangladesh improved nutritional status in poor rural women and children.Methods
The panel study involved a random sample of 895 households from over 50 000 enrolled in a cash-for-work programme between September and December 2007 and 921 similar control households. The height, weight and mid-upper arm circumference of one woman and child aged less than 5 years from each household were measured at baseline and at the end of the study (mean time: 10 weeks). Women reported 7-day household food expenditure and consumption on both occasions. Changes in parameters were compared between the two groups.Findings
At baseline, no significant difference existed between the groups. By the study end, the difference in mean mid-upper arm circumference between women in the intervention and control groups had widened by 2.29 mm and the difference in mean weight, by 0.88 kg. Among children, the difference in means between the two groups had also widened in favour of the intervention group for: height (0.08 cm; P < 0.05), weight (0.22 kg; P < 0.001), mid-upper arm circumference (1.41 mm; P < 0.001) and z-scores for height-for-age (0.02; P < 0.001), weight-for-age (0.17; P < 0.001), weight-for-height (0.23; P < 0.001) and mid-upper arm circumference (0.12; P < 0.001). Intervention households spent more on food and consumed more protein-rich food at the end of the study.Conclusion
The cash-for-work programme led to greater household food expenditure and consumption and women’s and children’s nutritional status improved. 相似文献18.
Badrinarayan Mishra Nidhi Dinesh Sinha Hitesh Gidwani Sushil Kumar Shukla Abhishek Kawatra SC Mehta 《Indian Journal of Community Medicine》2013,38(1):15-21
Background:
Blood pressure (BP) recording is the most commonly measured clinical parameter. Standing mercury sphygmomanometer is the most widely used equipment to record this. However, recording by sphygmomanometer is subject to observer and instrumental error. The different sources of equipment error are faulty manometer tube calibration, baseline deviations and improper arm bladder cuff dimensions. This is further compounded by a high prevalence of arm bladder miss-cuffing in the target population.Objectives:
The study was designed to assess the presence of equipment malcalibrations, cuff miss-matching and their effect on BP recording.Materials and Methods:
A cross-sectional check of all operational sphygmomanometers in a health university was carried out for the length of the manometer tube, deviation of resting mercury column from “0” level, the width and length of arm bladder cuff and extent of bladder cuff-mismatch with respect to outpatient attending population.Results:
From the total of 50 apparatus selected, 39 (78%) were from hospital setups and 11 (22%) from pre-clinical departments. A manometer height deficit of 13 mm was recorded in 36 (92.23%) of the equipment in hospital and 11 (100%) from pre-clinical departments. Instruments from both settings showed significant deviation from recommended dimensions in cuff bladder length, width and length to width ratio (P < 0.001). Significant number of apparatus from hospital setups showed presence of mercury manometer baseline deviation either below or above 0 mmHg at the resting state (χ2 = 5.61, D. F. = 1, P = 0.02). Positive corelationship was observed between manometer height deficit, baseline deviation and width of arm cuff bladder (Pearson correlation, P < 0.05). Bladder cuff mismatching in response to the target population was found at 48.52% for males and 36.76% for females. The cumulative effect of these factors can lead to an error in the range of 10-12 mmHg.Conclusion:
Faulty equipments and prevalent arm bladder cuff-mismatching can be important barriers to accurate BP measurement. 相似文献19.
Background:
Disturbances of menstrual bleeding are major social and medical problem for women and account for high percentage of gynecological visit.Objectives:
The objective of the study was to document menstrual abnormalities experienced by female college students, their awareness and health seeking behavior.Materials and Methods:
A cross-sectional survey was undertaken, 400 students were selected using stratified sampling technique and interviewed using semi-structured self-administered questionnaire. Inferential statistical analysis such as Chi-square test and logistic regressions were carried out.Results:
The mean age at menarche was 14.18 years. Irregular menstrual cycles were reported in 9.0%. Dysmenorrhea was present in 62.5%, and 12.5% reported school absenteeism. Students'' awareness of menstrual abnormalities was poor (29%). A few of them (10.5%) decided to seek help for menstrual abnormalities. The awareness of students on menstrual abnormalities was significantly influenced by their age (OR = 2.33, P = 0.03); however, age at menarche and level of study did not influence their awareness (OR = 0.45, P = 0.24 and OR = 1.42, P = 0.12). History of dysmenorrheal (OR = 10.2, P = 0.001) and academic disturbance (OR = 5.45, P = 0.001) had significant influence on the health seeking behavior of the students.Conclusion:
There was a general lack of information about menstrual issues and when to seek help. There is a need to educate female college students about menstrual issues in order to improve their health seeking behavior as regards menstrual abnormalities. 相似文献20.
Supon Limwattananon Viroj Tangcharoensathien Phusit Prakongsai 《Bulletin of the World Health Organization》2010,88(6):420-427