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स्वास्थ्य शिक्षा अनुसंधान एवं विकास जर्नल

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आयतन 4, मुद्दा 1 (2016)

शोध आलेख

Correlates of Health Communication Preferences in a Multiethnic Population of Pregnant Women and Mothers of Young Children

Katrina Daoud, Audra Gollenberg and Kim Fendley

Background: As posited in multiple health communication theories, it is vital to understand modern health communication preferences among communities in order to develop tailored interventions to reduce Infant Mortality (IM). Literature suggests that health communication inequalities play an important role in infant health knowledge gaps, thus contributing to the disparate IM rates. We sought to understand preferred methods of communication among expectant or mothers of young children of varying sociodemographics. We hypothesized that methods of communication would vary by sociodemographics.

Methods: A bilingual questionnaire, developed using community based participatory research principles was offered at pre-selected women's health agencies in the Shenandoah Valley of Virginia. Participants chose from a researched list of 22 methods of communication and also designated their "top three choices." Communication methods were compared across sociodemographics using chi-squared statistical tests.

Results: A total of 292 participants completed the questionnaire at the various sites. Participants were predominantly White (60%) or Hispanic/Latina (30%), and lived in Frederick county/Winchester city (77%). Of the 22 communication methods, the five most prevalent were: talking with a healthcare provider (91%), family or friends (85-87%), using internet (84%), and handouts/booklets (80%). Communication methods most frequently chosen as a "top three choice" were: internet (46%), talking with healthcare providers (33%), and talking with family (32%). A higher preference for talking with a healthcare provider was noted among higher income individuals (100%) compared to lower income (82%; p-value=0.0062), a higher preference for call-in hotlines among Hispanic (49%) vs. non-Hispanic women (15%; p-value<0.0001), and a higher preference for placemats at fast-food restaurants among older women (42%) compared to younger (16%, p-value=0.0361).

Conclusion: Results suggest the incorporation of multiple methods may be a practical approach to reaching different segments of the population including those identified as most vulnerable for infant mortality.

शोध आलेख

The Effect of an Integrated Savings and Community Based Health Education Program among Older Adults with Hypertension: A Quasi-Experimental Controlled Study, Bangkok Province, Thailand

Nethnapa Vongskan, Sathirakorn Pongpanich and Ratana Samrongthong

Introduction: Hypertension remains as the fifth leading cause of death in both females and males in Thailand. Complications of this disease are risk factors to both cerebrovascular and coronary artery diseases. Simultaneously, there is an increase in the proportion of older adults leading to an increase in high blood pressure cases including high incidence rate of hypertension and high burden of older adults’ health care cost while their income decline with lower rate of savings.

Objective: To examine the effectiveness of savings and health education model (SHE model) program, which is an integration of savings and community based health education for older adults with hypertension in Sai Mai and Klong Sam Wa districts, Bangkok, Thailand.

Methodology: Mixed methods using survey, quasi-experimental and qualitative techniques were employed. We examined KAP on hypertension in a random sample of 242 people suffering from hypertension by using the survey techniques including exploring the effectiveness of savings and health education model (SHE model) program in a random sample of 59 participants using quasi-experimental techniques from 2 communities. Focus group discussion was conducted with 27 participants to explore in-depth information related to care, prevention, and the effectiveness of SHE model program.

Results: Survey data found most participants had good basic knowledge regarding hypertensive care and prevention. 65.3% and 49.6% of respondents had positive attitudes and practice toward hypertension care and prevention. Data compiled from quasi-experimental study found that knowledge on hypertension had a significant difference on pre intervention. Negative attitude towards care and control had a positive correlation with practice. SBP-negative attitudes and practices were inversely related to DBP. However with knowledge, attitude, and practices, there were recorded improvements in all groups after intervention compared to the control group. Blood pressure improvements were noted post intervention. Community savings funds and effects of blood pressure control on material impact recorded from quasi-experimental study.

Conclusion: Improved hypertension health education effects had the most significant impact in controlling the disease in the community.

शोध आलेख

The General Surgery Residents Perception for the Training Program at the King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

Osman A Hamour, Zain Alshareef and Ahmed A Abdalla

Background: A good number of research work indicates that trainees as beneficiaries are usually the most equipped resources to evaluate the extent to which their learning and training experience is useful, informative, satisfactory, beneficial, and worthwhile. Although the trainees' assessment on such matters is not objective enough for the course effectiveness and instructional techniques, yet such a feedback is a reliable and legitimate indicator of the students' satisfaction. The aims of this study are to retrieve, understand, and critically examine the education program at the King Faisal Specialist Hospital and Research Center Jeddah, (KFSHRC-J) through the eyes of the end-users and the beneficiaries, the surgical residents.

Methods: This is an exploratory descriptive study, conducted at the KFSHRC-Jeddah, targeting the surgical resident's physicians who have recently finished their training. Self-Administered Questionnaire was used for data collection. Data processed using SPSS software program version 20.

Results: This is an exploratory descriptive study included 24 participants; 10 (41.7%) males and 14 (58.3%) females. Some residents believed that the ward rounds are not properly utilized for educational purposes, and only run as business rounds. All participants expressed the paramount need for increasing the hands-on experience of the residents each at his/her level and they recommended that the program should continue, but some changes has to be introduced and implemented, 3.6% of them suggest freezing of the program.

Conclusion: In conclusion we believe that the data collected shows that residents at this training program of the KFSHRC-J are generally satisfied with the surgical training they receive. Most of them rated the quality and volume of their surgical training as adequate and satisfactory and will improve if their suggestion shall be taken seriously studied and implemented.

शोध आलेख

An Assessment of Effectiveness of Drug Rehabilitation Programs in Kisii County- Kenya

Ben Nyachwaya Sereta, Fred A Amimo, Peter Ouma and Thomas Orind Ondimu

According to the World Drug Report, approximately 200 million people, about 5% of the World’s population aged between 15 and 64 years have either been forced or voluntarily sought the help of rehabilitation centers for behavioral modifications [1]. These rehabilitation centers over the years have admitted drug addicts into their rehabilitation programs meant to bring about behavior change among the rehabilitees. However, little is known about the effectiveness of drug rehabilitation programs on behavior modification of drug addicts in rehabilitation centers in Kisii County and its environs. Subsequently, no one has established whether the existing rehabilitation programs put in place to help the drug addicts are functional. The study employed the cross sectional design as a method of data collection. The study population was the staff and the rehabilitees of purposively sampled ten rehabilitation centers in Kisii County and its environs. A pre-test was carried out in three randomly selected rehabilitation centers which were not to be part of the final study group.

Questionnaires were used as tools for collecting data, one for the staff and questionnaire-guided interviews for the rehabilitees. Data was coded and entered in to the Statistical Package for Social Scientists (SPSS Ver. 10) software and descriptive statistics such as frequencies and percentages calculated. The study employed the matrix model to achieve its objectives. The study sought to prove the Cognitive Theory which has profound implications for the rehabilitees in rehabilitation centers in Kisii County and its environs.

The study mainly found that; Drug users ’evaluation in terms of assessment emerged the key programs offered by rehabilitation centers in Kisii County and its environs; staff members in rehabilitation centers in Kisii County were sufficiently trained, with a good number of them holding degrees, diplomas and certificates from reputable institutions. They also possess proficiency in drug management and rehabilitation tasks. Rehabilitation centers in Kisii County and its environs carried personal continuing / aftercare services to their clients using psychological interventions, and individual personal empowerment of the rehabilitee. Financial impediments like lack of sufficient staff, medication and facilities as well as inconsistent follow ups are major challenges facing rehabilitation centers in Kisii County. These challenges can only be curbed by sufficient funding of these institutions to enable employment of adequate staff and acquisition of better infrastructure to enable enhanced individual attention to rehabilitees. The study recommended that; rehabilitation centers management should foster establishment and implementation of a comprehensive drug rehabilitation schedule that caters to the individual needs of a rehabilitee and at the same time manage rehab time to avoid boredom among the patients. Rehabilitation centers staff should gain insights on various needs of the rehabilitees to avoid unnecessary strife in the rehabs. They should also learn to handle the rehabilitees with professionalism to enable a successful rehabilitation process. Rehabilitees in the rehabilitation program should also learn a number of personal management tips to help them adequately plan for and make the most out of personal management tips for the period they are in the rehab center. The ministry of special programs should look into various problems encountered by staff and clients in rehabilitation centers. The ministry should then formulate policies on the funding and staffing of these centers to facilitate a sound drug rehabilitation process.

शोध आलेख

Novel Therapeutic Approach for Parkinson Disease during REM Sleep

Miguel Angel Pieroni and Pablo Gustavo Pieroni

Study objectives: The physiological responses of an individual depend on preset limits. They must be able to adapt it to changing environmental conditions, modifying the thresholds. We propose a regulatory function of biological responses during REM sleep. Responses previously developed during wakefulness, are evaluated and regulated for integration into the repertoire of responses during sleep. The aims of this study were to evaluate the impact of the restoration of REM sleep in patients with Parkinson disease by stimulation of D2 receptors and to evaluate the symptomatic benefit of this approach.

Methods: Ten parkinsonian patients underwent a polysomnography study using nocturnal apomorphine subcutaneous administration at the beginning of each REM detected along all night recording.

Results: This therapeutic approach led to a significant benefit for patients in all of three UPDRS scores. The mean UPDRS III motor examination “On” scores (mean ± SD) were reduced by 9.4 ± 8.5 points (p<0.0001). For patients in the UPDRS II scores a total difference of 12 ± 4.22 to 5.2 ± 5.22 (p<0.0001) were observed; and in total UPDRS I the difference was of 5.2 points (p<0.0001), with a reduction from 8.4 ± 3.2 to 3.2 ± 3.1.

Conclusion: Sleep alteration can be improved by stimulation of D2 receptors. The symptomatic benefits obtained linked to the restoration of REM functions in patients with PD were significant.

शोध आलेख

Questionnaire Survey for Assessing the Present Condition of Children with Eating Disorders in Japanese Schools

Kaoru Seike, Michiko Nakazato, Hisashi Hanazawa, Toshiyuki Ohtani, Tomihisa Niitsu, Shinichi Ishikawa, Atsuko Ayabe, Ryoko Otani, Kentaro Kawabe, Fumie Horiuchi, Shizuo Takamiya and Ryoichi Sakuta

Background: As the proportion of teens in the onset ages has increased, it has become important to detect eating disorder (ED) students early in school and clarify the way of support. Though epidemiological surveys of Yogo teachers have been conducted to inquire the number of ED students, none of these were based on DSM-5. Thus, we conducted a wide area survey in Japan for proposing a better framework of support for Yogo teachers in the early detection/support of ED students.

Methods: A questionnaire survey organized by ED type (based on DSM-5) was administered to Yogo teachers working at elementary/junior high/senior high/special needs schools in four prefectures of Japan in 2015, and 1886 responses were obtained. Based on the results, the encounter rates (the proportions of Yogo teachers who had met ED students) were calculated, and factors affecting them were examined by logistic regression analysis.

Results: The order of the encounter rates of the ED type was Anorexia Nervosa (AN)>Bulimia Nervosa (BN)>Avoidant/Restrictive Food Intake Disorder (ARFID)>Binge Eating Disorder (BED)>others. The factors significantly affecting the rates were location, school type, number of students, experience years, and AN knowledge for AN, school type, experience years, BN knowledge for BN, location, school type, experience years, BED knowledge for BED, location, experience years, ARFID knowledge for ARFID and school type, experience years, Others knowledge for Others.

Conclusions: Since the encounter rate of AN was highest, providing support for AN would be effective. Moreover, a factor affecting the rate of all ED types was the ED knowledge. Senior high schools had the highest rates for AN, BN and BED, and special needs schools had the highest for others. These findings imply that for detecting/supporting ED students early, it is necessary to offer knowledge of the corresponding ED type to Yogo teachers at the corresponding school type.

शोध आलेख

Long Scarf Syndrome; Accidental Strangulation due to Long Scarf

Zafarullah Beigh, Ihsan Ali and Rauf Ahmad

Loose clothing worn by Indian women get accidently entangled in moving wheel of motor bike or crop thresher and cause accidental strangulation. This study is about the patients admitted in department of otorhinolaryngology with history of accidental strangulation due to long scarf. This study showed that women in rural area are at risk of accidental strangulation due to long scarf getting entrapped in crop thresher, similarly women in urban area are also at risk of accidental strangulation when they sit on the back seat of motor bike and long end of scarf get entrapped into spoke of the moving wheel. Bruise on the anterior neck is most common injury found in our study and associated injury to head was very common.

शोध आलेख

Albino Skin Cancer will End if a Communitys Cancer Surveillance Program is Successful

Onuigbo WIB

The new emphasis on cancer surveillance research (CSR) encompasses many approaches. Therefore, this paper examines the huge problem raised by the burden of cancer on Nigerian albinos. First, its grievousness is illustrated. Next, it is advanced that shielding albinos from sunlight right from childhood will repay dividends, especially if mothers are attentive and Governments are admissive of a most moving message, namely, that the preventive policy option is that indoor employment should be reserved for these disadvantaged members of the population.

शोध आलेख

Physical Profile of Preterm Children in Ahmednagar District of Maharashtra, India

Waghavkar SN and Ganvir SS

With survival rates of preterm and low-birth weight infants improving, there is an increase in the number of these infants with motor impairments later in life, ranging from developmental coordination disorder to cerebral palsy (CP). Infant neuromotor examinations are performed for a variety of purposes, including discriminating between infants who have motor dysfunction and those who are developing typically (discriminative tool), predicting which infants will have future motor problems from current performance (predictive tool), and evaluating changes over time (evaluative tool).

Objective: This report describes the physical and functional status of preterm and low birth infants in Ahmednagar district of Maharashtra.

Method: An observational study was conducted in which INFANIB was administered on 43 preterm and low birth weight infants with corrected age of 10 days-120 days. All the components of INFANIB were administered to these infants except component no. 11,12,16,17. After administration of INFANIB the score from each component were summed together and calculated the final score. According to these final score each infant were categorized into 3 categories that is Normal, Abnormal and Transient. Results: According to standard cut off points of INFANIB 4 infants were fall in Abnormal category and remaining 39 infants were fall in category of transient. When mean was calculated of all the components of INFANIB we found that the 2nd and 5th component is more affected when compare with other component (mean=2.9, 2.8, resp.). When the total mean score compared with Degree of Normality to abnormality with age 7 months or less we found that all the infants are fall into moderately abnormal category (mean=55.5).

Conclusion: The present study concluded that when INFANIB is administered to assess the physical profile of preterm children in Ahmednagar city out of 43 patients 4 infants were fall in Abnormal category and remaining 39 infants were fall in category of transient.

समीक्षा लेख

Global Health Report Community Acquired Methicillin-Resistant Staphylococcus aureus

Hope Honigsberg RN

Staphylococcus infections are a global issue that can seriously impact the health of the communities. The presence of staphylococcus infections have traditionally been observed within the healthcare settings. Although, recently there has been an increase on the diagnosis of staphylococcus infections throughout the community. The development of this community acquired epidemic may be due to the lack of the public’s education involving the infection, the empirical prescribing of antibiotics by healthcare providers, and the patient’s misuse or misunderstanding of antibiotics. The purpose of this paper is to provide insight on community acquired methicillinresistant staphylococcus (CA-MRSA), its impact on the global community, and how the community health nurse can help provide awareness on CA-MRSA.

शोध आलेख

Are Patients Undergoing an Elective Myocardial Revascularization Nowadays at Worse Pre-Surgery Quality of Life than Before?

Ellen van der Straaten and Luc Noyez

Background: The purpose of this study is to outline whether patients, undergoing elective myocardial revascularization nowadays have a better or worse preoperative Quality of Life (QoL) than years ago. Methods: The EuroQol instrument, EQ-5D and EQ-VAS is used for assessing QoL. Preoperative QoL data of 3175 patients undergoing elective isolated coronary bypass operations, January 2002–December 2013 were analyzed. The total group was divided into three time cohorts. Group A (879 patients) operated between January 2002 and December 2005, group B (944 patients) operated between January 2006 and December 2009, and group C (1352 patients) operated between January 2010 and December 2013 (n=803).

Results: There is no statistical significant difference among the three groups for the registered EQ-5D index. The registered EQ-VAS index is significantly lower for group A versus B and C (p=0.001). The domains of the EQ-5D, ‘mobility’, ‘usual activities’ and ‘pain/discomfort’ show a statistically significant difference over time with an increased percentage of patients with no problems in these domains. However, in contrast with these domains, the domain anxiety/depression, shows, a statistical significant increase of the percentage patients with problems.

Conclusion: Patients nowadays are not at a worse QoL than years ago. Nevertheless, the percentage of patients with anxiety and problems of depression increased the last years.

शोध आलेख

Effectiveness of an Alcohol Use Prevention Program for Low-Income Youths in Gangneung, South Korea

Sang-A Kim, Woong-Sub Park, In Han Song  

The study is to examine the effectiveness of an alcohol use prevention program to reduce the risk of drinking among low-income youth. In order to explore the effectiveness of alcohol use prevention program, elementary school students from low-income families were divided into intervention and comparison groups. The program was carried out with 328 elementary school students attending after-school programs at the community youth centers located in Gangneung, Gangwon Province, South Korea. After completing the program, the alcohol expectancy score (p<0.001) was significantly lowered in the intervention group, while there was no significant change in the comparison group. The results showed that the moderating effects of grade group (p=0.04) and self-assertiveness (p=0.03) were significant on the relationship between the program and the scores of alcohol expectancy after controlling for gender, age, and self-assertiveness. Based on these findings, this study suggests for considering youths’ age group and their self-assertiveness in planning and implementing alcohol use prevention programs for them.

शोध आलेख

The East Metro American Indian Diabetes Initiative: Engaging Indigenous Men in Reclaiming Health and Spirituality through Community-Based Participatory Research

Kirsten Lind Seal, Melissa W. Blum, Katharine Wickel Didericksen, Tai Justin Mendenhall, Noah Eshon Gagner, Betty Ann GreenCrow, Kathleen Nannette LittleWalker, Steven Alfred Brownowl and Kerry Benton

Diabetes affects American Indian people at higher rates than the general US population; within this community gender disparities overwhelmingly affect men's health. Using Community-based participatory research (CBPR) and talking circles we asked AI male participants to share their perspectives about which culturally inclusive features of the program serve to best engage them and contribute to improved health (e.g., purposefully integrating sacred cultural and spiritual activities, reclaiming roles as strong and valued family men, and giving support appear to facilitate behavior change and health/disease management). Future directions and implications for partnership with AI communities are offered.

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