Perception of the threat, mental health burden, and healthcare-seeking behavior change among psoriasis patients during the COVID-19 pandemic

This study aimed to investigate the perceived threat, mental health outcomes, behavior changes, and associated predictors among psoriasis patients during the COVID-19 pandemic. The COVID-19 has been known to increase the health risks of patients with psoriasis owing to patients’ immune dysregulation, comorbidities, and immunosuppressive drug use. A total of 423 psoriasis patients not infected with COVID-19 was recruited from the Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Chang Gung Memorial Hospital, and China Medical University Hospital from May 2020 to July 2020. A self-administered questionnaire was used to evaluate the perceived threat, mental health, and psychological impact on psoriasis patients using the Perceived COVID-19-Related Risk Scale score for Psoriasis (PCRSP), depression, anxiety, insomnia, and stress-associated symptoms (DAISS) scales, and Impact of Event Scale-Revised (IES-R), respectively. Over 94% of 423 patients with psoriasis perceived threat to be ≥ 1 due to COVID-19; 18% of the patients experienced psychological symptoms more frequently ≥ 1, and 22% perceived psychological impact during the pandemic to be ≥ 1. Multivariable linear regression showed that the higher psoriasis severity and comorbidities were significantly associated with higher PCRSP, DAISS, and IES-R scores. The requirement for a prolonged prescription and canceling or deferring clinic visits for psoriasis treatment among patients are the two most common healthcare-seeking behavior changes during the COVID-19 pandemic. Psoriasis patients who perceived a higher COVID-19 threat were more likely to require a prolonged prescription and have their clinic visits canceled or deferred. Surveillance of the psychological consequences in psoriasis patients due to COVID-19 must be implemented to avoid psychological consequences and inappropriate treatment delays or withdrawal.

Health and Culture: The Association between Healthcare Preferences for Non-Acute Conditions, Human Values and Social Norms

Preference for professional vs. non-professional or informal healthcare for non-acute medical situations influences healthcare use and varies strongly across countries. Important individual and country-level drivers of these preferences may be human values (the fundamental values that individuals hold and guide their behavior) and country-level characteristics such as social tightness (societal pressure for “acceptable” behavior). The aim of this study was to examine the relation of these individual and country-level characteristics with healthcare preferences. We examined European Social Survey data from 23,312 individuals in 16 European countries, using a multi-level, random effect approach, including individual and country-level factors. Healthcare preferences were explained by both human values (i.e., Schwartz values) and societal tightness (i.e., tightness-looseness scores by Gelfand). Stronger conservation increased, whereas self-transcendence and openness to change decreased preference for professional healthcare. In socially tight countries, we found a higher preference for professional healthcare. Furthermore, we found interactions between social tightness and human values. These results suggest that professional healthcare preference is related to both people’s values and societal tightness. This improved understanding is useful for both predicting and channeling healthcare seeking behavior across and within nations.

RELIGIOUS COMMITMENT AS A PREDICTOR OF HEALTHCARE SEEKING BEHAVIOR AMONG RURAL DWELLERS IN KOGI STATE

In recent years, efforts have been devoted to enhancing the health care system of Nigeria to provide efficient and reliable health care services to the people. However, insinuations suggest that many people are not utilizing the available healthcare facilities, especially in rural communities. Perhaps, religious attachment is a significant determinant of several behavioral domains. The present study aimed to examine variations in HSB among the rural dwellers of Kogi State, Nigeria, based on religious commitment. Two hundred and sixty-nine Muslim and Christian worshipers chosen from religious centers in different locations of the state participated in the study. The respondents completed a self-report measure of healthcare-seeking behavior and the religious commitment inventory. The result of regression analysis indicated a positive influence of religious commitment on healthcare-seeking behaviors in rural populations. It was concluded that religious commitment should be included in the focus of the healthcare providers in providing all-inclusive care for rural dwellers in Kogi state.

Magnitude of Common Childhood Illness, Health Care Seeking Behavior, and Associated Factors in Efratana Gidim District, East Amhara, Ethiopia, 2020

Background Childhood infectious illness mainly diarrheal diseases, febrile illnesses, and acute respiratory tract infection remains the leading cause of morbidity and mortality among children below five years. Delay and inappropriate healthcare-seeking behavior of caregivers’ were the major reason for under-five child death in developing countries including Ethiopia. According to WHO, a timely healthcare-seeking practice can effectively save the lives of children by 20%, particularly from ARIs, and significantly minimize morbidities. Therefore the aim of this study was to assess the magnitude of common childhood illness, healthcare-seeking behavior, and associated factors in Efratana Gidim District, East Amhara, Ethiopia, 2020. Methods A community based crossectional study was conducted from March 15 to April 15, 2020, among urban and rural respondents. Multistage sampling technique was employed with a total of 661 respondents by using semi-structured questionnaire through face to face interviews. Bivariate and multivariate logistic regression analyses were carried out to assess the association between healthcare-seeking behavior and predictor variables. Odds ratio along with 95% confidence interval was used to measure the strength of associations and statistical significance was considered at p-value < 0.05. Results the overall two weeks prevalence of childhood illness was 24.1%, (95% CI: 21.1%-27.3%) and 59.1%, (95% CI: 51.1%-66.8%) of caregivers sought treatment at health facility. Moreover, fever, cough, and diarrhea accounted for 16.9%, 16.8%, and 11% respectively. Caregivers’ level of education (AOR = 2.56:95%CI: 1.09, 5.99) and residence (0.26: 95%CI: 0.09, 0.73) were significant factors for childhood illness and experience of child death (AOR = 3.766; 95%CI: 1.726, 8.873), diarrheal symptoms (AOR = 3.914; 95%CI: 2.043, 10.828) and access to transportation (AOR = 3.352; 95%CI: 1.049, 10.710) were predictors of healthcare seeking behavior of caregivers. Conclusion the prevalence of common childhood illness was high however; treatment-seeking behavior of caregivers for common childhood illness was low. Caregivers’ experience of child death before, symptoms of diarrhea, and access to transportation were predictors of Healthcare-seeking behavior. Therefore repeated health education on basic prevention measures of common childhood illnesses and health promotion strategies to enhance caregivers’ Healthcare-seeking behavior are critically important. .

Can a Multitiered Copayment System Affect People’s Healthcare-seeking Behavior? A Case Study of Wenzhou, China

Background. Facilitating the primary health care (PHC) system and maintaining people’s reasonable health-seeking behavior are key to establishing a sustainable healthcare system. China has employed a multitiered copayment system to incentivize the public to utilize PHC services through its hierarchical medical care system; however, most people still prefer visiting tertiary care hospitals. Methods. This preliminary study was conducted in 2016 on 1831 individuals from four regions of Wenzhou in Zhejiang Province to explore the effect and influencing factors of the multitiered copayment system that drives their primary healthcare-seeking behavior. We question whether a quality gap in healthcare services influences the minimal effect of the multitiered copayment system, which existing literature has considered as an important factor in the lack of reform in the Chinese healthcare system. We discuss the effect of the policy following the current situation in which there exists a large gap and further consider the hypothetical situation of a reduced gap in the future. Result. The results indicate that the initial effects of the multitiered copayment system was limited. However, they become more pronounced after the equalization of the quality of healthcare services. Moreover, the main determinants in people’s selection of PHC institutions changed from age and needs variables (self-rated health status) to age and enabling variables (distance to a medical care facility). Conclusion. This study confirms that changes in the quality gap in healthcare services influence the multitiered copayment system. Hence, reducing this gap can help to achieve the intended outcome of the tiered healthcare insurance schedule.

Disparities in mothers’ healthcare seeking behavior for common childhood morbidities in Ethiopia: based on nationally representative data

Background Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers’ healthcare-seeking behavior for their under five children. Methods The study used the Ethiopian Demographic and Health Surveys (EDHS) data. The EDHS is a cross sectional survey conducted in 2016 on a nationally representative sample of 10,641 respondents. The main determinants of care-seeking during diarrhea and acute respiratory infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design. Results Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of 2 weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for literate fathers compared to those with no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced Intimate Partner Violence (IPV) violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI. Conclusions The findings call for more coordinated efforts to ensure equitable access to health care services focusing on mothers living in deprived household environment. Strengthening partnerships with public facilities, private health care practitioners, and community-based organizations in rural areas would help further improve access to the services.

Mental Healthcare-Seeking Behavior during The Perinatal Period among Rural Women in Bangladesh

Introduction: Mental health conditions are of rising concern due to their increased contribution to the global burden of disease. Mental health issues are inextricably linked with other sociocultural and health dimensions, especially in the rural areas in developing countries. The complex relationship between mental health issues and sociocultural settings may largely toll upon the healthcare-seeking behavior. Evidence suggests that mental illness affects more than 10% of women and one year after childbirth. So, it urges to document the current status of mental healthcare-seeking behavior during the perinatal period among rural women in Bangladesh to develop a context-specific intervention in the future.Methods: This study was carried out in one sub-district in Bangladesh from April 2017 to June 2018. We conducted 21 In-depth Interviews and seven Focus Group Discussions with different groups of purposively selected participants such as perinatal women, head of the family, community stakeholders, and community level healthcare providers. After collecting the recorded interview and making the verbatim transcription, the data were coded through Atlasti 5.7.a. Data were analyzed thematically to explain the findings.Results: Most of the women with mental disorders at the community level did not seek healthcare during the perinatal period. Women with mental illness also did not know who and where the mental health services are provided. The study found that only one respondent out of twenty-one sought maternal mental healthcare from a gynecologist from a private hospital. In this regard, socio-cultural factors such as social stigma traditional beliefs and practices, social and religious taboos, and social capital also negatively influence healthcare-seeking behaviors. Besides, the community-level service providers were not trained and did not have any guidelines regarding its proper management.Conclusion: The study findings provide us evidence that there is an urgent need to increase the awareness for service users and formulate a guideline for the community-level service provider to manage maternal mental problems during the perinatal period of women in rural Bangladesh.