China ; epidemiology ; Humans ; Patient Acceptance of Health Care ; Tuberculosis, Pulmonary ; epidemiology ; psychology

BACKGROUNDPrehospital delay remains one of the main causes of reduced benefit of reperfusion therapy for patients with acute myocardial infarction (AMI). The largest proportion of prehospital delay involves the interval between the onset of symptoms and the decision to seek medical treatment. The purpose of this study was to examine the factors associated with the extent of care-seeking delay in Beijing for patients with AMI.

METHODSA structured interview was conducted in 102 patients with AMI in eight hospitals in Beijing.

RESULTSThe mean decision time in patients with AMI was (204 +/- 43) minutes, and prehospital delay time was (311 +/- 54) minutes. Only 34% of patients sought medical care within one hour and a further 36% of patients presented to one of the eight hospitals within two hours after onset. Educational level, atypical presentation of AMI, and family members at the site where AMI occurred were associated with longer delay time in seeking medical assistance (P < 0.05, respectively), whereas the intensity of chest pain was inversely related to patients' delay time (P < 0.01). Patients who perceived their family relationship as good, attributed their symptoms to AMI origin, knew the time-dependent nature of reperfusion therapy, or used emergency medical service tended to seek medical care in a more rapid manner (P < 0.05, respectively).

CONCLUSIONSPatients with AMI in Beijing delay seeking medical care to a great extent. Health education to increase the level of awareness of the target population at increased risk of AMI, including patients and their family members, is probably beneficial to reduce patients' care-seeking delay.

Cognition ; Female ; Humans ; Male ; Myocardial Infarction ; psychology ; therapy ; Patient Acceptance of Health Care ; Regression Analysis ; Time Factors

COVID-19/psychology* ; Child ; Child Health ; Health Care Rationing ; Health Policy ; Health Services Accessibility ; Humans ; Pandemics ; Parents/psychology* ; Patient Acceptance of Health Care ; Singapore/epidemiology*

PURPOSE: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. METHODS: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. RESULTS: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis.treatment-related-words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression-words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician.husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband . people . mother . physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past . present . future'. CONCLUSION: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.
Family Relations ; Female ; Humans ; Male ; Neoplasms/diagnosis/*psychology/therapy ; Patient Acceptance of Health Care ; Professional-Patient Relations ; Program Development ; Self Care ; User-Computer Interface

OBJECTIVETo assess the acceptability and influence factors of early antiretroviral therapy (ART) among HIV-positive men who have sex with men (MSM) .

METHODSFrom June to August 2012, through convenience sampling, HIV-positive MSM who were willing to cooperate with the survey were selected from the Hangzhou and Ningbo AIDS prevention and control database. A total of 280 HIV-positive MSM who did not receive ART participated in the study.Using self-designed questionnaire, general demographic information, awareness of AIDS knowledge, sexual behavior, use of condom, current physical condition, awareness and attitude towards early ART were investigated.Excluding 60 HIV-infected MSM whose CD4(+)T count didn't meet the inclusion criteria, a total of 220 subjects were included in the analysis. Chi-square was used to compare the difference of early ART acceptance among subjects with different characteristics.Non-conditional logistic regression was used to analyze the influence factors of the acceptability of early ART.

RESULTSThe acceptance rate of early ART among HIV-infected MSM was 62.7% (138/220). Delaying the disease development, preventing partners from infection, not worrying others to suspect them of having HIV, and partners unknowing the HIV-infected status were the factors which had a relatively higher acceptance rate of early ART. Correspondingly, the acceptance rate was 68.8% (130/189), 68.7% (103/150), 78.4% (69/88) and 72.5% (74/102) respectively and the acceptance rate among subjects with opposite opinions or characteristics was 24.1% (7/29) , 50.0% (30/60), 52.7% (68/129) and 45.8% (58/107) respectively (chi-square values were 21.46, 6.43, 14.84 7.55, all P values <0.05).Logistic regression analysis showed that delaying the disease development (OR = 11.50, 95%CI:3.29-40.22) and preventing partners from infection (OR = 3.72, 95%CI:1.53-9.03) were inclined to the acceptance of early ATR.While concerning others' suspection of them having HIV (OR = 0.19, 95%CI:0.08-0.48) and partners knowing the HIV-infected status were inclined to unacceptance of ART(OR = 0.31, 95%CI:0.13-0.70).

CONCLUSIONThe acceptability of early ART among HIV-positive MSM is high. The recognition of early ART and concern of privacy leak are the major influence factors which can stimulate the acceptance of early ART.

Adolescent ; Adult ; Antiretroviral Therapy, Highly Active ; HIV Infections ; drug therapy ; prevention & control ; psychology ; Homosexuality, Male ; psychology ; Humans ; Logistic Models ; Male ; Middle Aged ; Patient Acceptance of Health Care ; Young Adult

Adult ; Behavior ; Female ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care ; psychology ; statistics & numerical data ; Substance-Related Disorders ; psychology ; Young Adult

In this study, we conducted an investigation among medical workers, patients and college students concerning their acceptability of breast palpation performed by male doctors (hereinafter referred to as "acceptability", or "the examination", respectively, if not otherwise indicated), to get the information about their acceptability and reasons for accepting or declining the examination among the three population. A questionnaire investigation was conducted in 500 patients with breast diseases, 700 students of medical colleges, and 280 medical workers working in hospitals. The subjects were asked to choose between two options: accept or do not accept (the examination). The subjects were asked to fill out the questionnaire forms on free and anonymous basis and the questionnaire forms were collected on spot, immediately after completion. The questionnaires collected were coded, sorted out and checked. Data of the eligible questionnaires were input into Epidata software and analyzed by SPSS. Upon the establishment of the database, the intra-group data were tested by utilizing χ(2) test. Among 1480 questionnaires, 1293 (90.41%) questionnaires were retrieved. Our results showed that 56.78% of patients reported that they could accept breast palpation by male doctors. About 59.66% of medical staff expressed their acceptance of the examination, but only 35.03% of students said the examination. On the basis of this study, we were led to conclude that the examination is not well accepted by different populations, and therefore, (1) medical professionals and administrators should pay attention to the gender-related ethics in their practice and the feeling of patients should be respected when medical examinations involve private or sensitive body parts; (2) to this end, related departments should be properly staffed with doctors of both sexes, and this is especially true of the departments involving the examination or treatment of private or sensitive body parts; (3) health education should, among other things, include helping female patients to overcome the fear and anxiety in such examinations. This is of great importance since some women may miss the opportunity to get timely diagnosis.
Adult ; Asian Continental Ancestry Group ; Female ; Health Personnel ; psychology ; Humans ; Male ; Mammary Glands, Human ; physiology ; physiopathology ; Middle Aged ; Outpatients ; psychology ; Palpation ; psychology ; Patient Acceptance of Health Care ; ethnology ; psychology ; Physical Examination ; ethics ; Physicians ; ethics ; Students, Medical ; psychology ; Surveys and Questionnaires

BACKGROUND/AIMS: Colorectal cancer, one of the most common cancers in developed countries, is curable when diagnosed at an early stage. However, for better screening, both a test that patients will tolerate and diagnostic accuracy are required. We compared patient experiences and preferences between computed tomographic (CT) colonography and conventional colonoscopy (CC) under conscious sedation. METHODS: Patients referred to the gastrointestinal clinic for CC were enrolled to also undergo CT colonography prior to CC. After each procedure, patients completed a questionnaire in which variables, such as abdominal pain, abdominal discomfort, and loss of dignity, were assessed using a 7-point Likert scale, with the highest score representing the worst experience. To verify response stability, a telephone questionnaire followed within 24 h after each procedure. Patients were then asked about their preference for CT colonography or CC. RESULTS: Data were collected from 51 patients who fulfilled all requirements, including CT colonography, CC, the two questionnaires after each procedure, and a follow-up questionnaire. Severity of abdominal pain, abdominal discomfort, and a loss of dignity were reported to be higher in CT colonography than in CC (p<0.01). In addition, the preference for CC was significantly higher than that for CT colonography (p<0.01). CONCLUSIONS: Although CT colonography is a safe and noninvasive screening test for colorectal cancer, further study is required to increase patient acceptance.
Colonography, Computed Tomographic/*methods/psychology ; Colonoscopy/*methods/psychology ; Colorectal Neoplasms/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Mass Screening/*methods/psychology ; Middle Aged ; Patient Acceptance of Health Care/*psychology ; *Patient Satisfaction ; Prospective Studies ; Questionnaires

PURPOSE: This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. METHODS: The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. RESULTS: Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. CONCLUSIONS: The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.
*Decision Making ; *Decision Trees ; Female ; Humans ; Korea ; Logistic Models ; Male ; Middle Aged ; *Models, Theoretical ; *Patient Acceptance of Health Care ; Reproducibility of Results ; *Stroke/psychology/therapy ; Time Factors

PURPOSE: The purpose of this study was to explore the health-illness transition of patients with Young-Onset Parkinson's Disease (YOPD). METHODS: From June to November 2011, 17 patients with YOPD who visited a neurologic clinic in a tertiary hospital participated in the study. Data were collected through in-depth interviews and analyzed using the grounded theory of Strauss and Corbin. RESULTS: The core category of the participants' health-illness transition emerged as 'reshaping identity following uncontrollable changes'. The participants' health-illness transition process consisted of six phases in sequence: ego withdrawal, loss of role, frustration, change of thought, modification of life tract, and second life. Although most participants proceeded through the six phases chronologically, some returned to the frustration phase and then took up the remaining phases. CONCLUSION: The study results provide an in-depth understanding of health-illness transition experiences in the participants. These findings suggest a need to develop appropriate nursing intervention strategies according to the different phases in the health-illness transition of patients with YOPD.
*Adaptation, Physiological ; Adult ; Age of Onset ; Female ; Humans ; Interviews as Topic ; Laughter Therapy ; Male ; Middle Aged ; Parkinson Disease/*psychology ; Patient Acceptance of Health Care ; Self Concept ; Social Isolation