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Knowing when but not how! - Mothers' perceptions and use of antibiotics in a rural area of Viet Nam

TROPICAL DOCTOR 2000年第1期30卷 6-10页

作者： Halfvarsson, J Heijne, N Ljungman, P Ham, MN Holmgren, G Tomson, G Uong Bi Hospital Quang Ninh Province Viet Nam.

Given the world-wide focus on how to rationally use antibiotics, national drug policy programmes have been developed in many countries in order to minimize the environmental antibiotic pressure and thereby hopefully limit increasing bacterial resistance. This study investigated perceptions of antibiotics in a health system with weak drug regulation. The study was conducted in two rural communes in Viet Nam, with a drug market characterized by the increased accessibility and consumption of pharmaceuticals. The study focused on rural mothers' perceptions and use of antibiotics in the treatment of acute respiratory infections (ARI) in children 5 years and under. A combination of qualitative and quantitative methods were used including key informant interviews, focus group discussions, and interviews with mothers and drug vendors. The study demonstrated that using a combination of qualitative and quantitative methods gives a better understanding of the prevailing perceptions and use of antibiotics in communities. The results showed that the mothers recognized well the signs of severe ARI and that antibiotics were reserved for more severe illness episodes, where penicillin V and ampicillin were first drugs of choice. However, the mothers' perceptions and use of antibiotics reflects indigenization of antibiotics into traditional Vietnamese thinking and medical practice. This resulted in self-medication and a respect for antibiotics from the mothers point of view. A first step towards the rational use of antibiotics is already taken where mothers, as the health decisionmaker, know when to initiate antibiotic treatment and try to limit unnecessary use of antibiotics. The next step is to develop a well-functioning health education programme in order to promote the correct use of antibiotics for a successful clinical outcome. This requires acknowledgement of the mothers' culture based behaviour.

关键词：急性病抗菌药/治疗应用健康态度/人种学药物利用集中研讨小组健康教育/组织和管理健康知识态度实践医学东方传统母亲/教育母亲/心理学问卷调查呼吸道感染/药物疗法农村卫生/统计学和数值数据自我投药法/方法自我投药法/统计学和数值数据越南成年人儿童学龄前女(雌)性人类男(雄)性

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Patterns of Illness Behavior Among Rural Elderly: Preliminary Results of a Health Diary Study

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The Journal of Rural Health 1992年第1期8卷 13-26页

作者： Stoller, Eleanor Palo Forster, Lorna Earl State University of New York Plattsburgh New York United States Clinton Community College in Plattsburgh New York United States

This paper summarizes the responses of rural elderly people to a variety of symptoms experienced during a three‐week period. Responses to symptoms included causal attributions, consultation patterns, and intervention strategies. Data recorded in diaries during a three‐week period highlight the importance of lay care in the illnesses of older people. Most symptoms were managed by older respondents themselves. When symptoms were discussed with someone else, the consultant was most likely a family member or friend rather than a health care professional. Only one third of the respondents contacted any formal provider about any of their symptoms. The majority of respondents combined medical and nonmedical explanations in interpreting their symptoms. The most frequent response to a symptom was doing nothing. The next two most commonly reported interventions were over‐the‐counter medications and activity limitation. Analyses revealed few differences among residential categories in patterns of illness behavior. Rural‐urban differences often disappeared when controlling for demographic and socioeconomic background which covarv with residence. Copyright © 1992, Wiley Blackwell. All rights reserved

关键词：文献工作/统计学和数值数据老年人身心健康评价卫生服务需求健康调查病案纽约病人接受卫生保健的程度/统计学和数值数据回归分析农村卫生/统计学和数值数据自我护理/统计学和数值数据自我护理/利用自我投药法/统计学和数值数据自我投药法/利用疾病角色社会经济因素城市卫生/统计学和数值数据老年人女(雌)性人类男(雄)性

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Self‐Care and Illness Response Behaviors in a Frontier Area: Rural Health Research

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The Journal of Rural Health 1992年第1期8卷 4-12页

作者： Bartlome, Jeffrey A. Bartlome, Patricia Bradham, Douglas D. 1 Bartlome is director of the Institute of Rural Health Studies in the College of Health Related Professions at Idaho State University. He is currently a doctoral candidate in the Department of Pharmacy Practice and Administrative Sciences College of Pharmacy. His research interests include pharmaceutical health care with emphasis in areas of rural primary health issues of providers and consumers.2 Bartlome is assistant professor in the Department of Pharmacy Practice and Administrative Sciences in the College of Pharmacy at Idaho State University. She received her doctorate followed by a residency and the ASHP Post-Doctorate Fellowship in Geriatric Pharmacotherapy at the University of Utah. Her research interests include pharmacotherapeutic effects on physical and psychological function of geriatric patients primary care chronic disease management and patient medication education.3 Bradham is an associate professor in the Department of Health Policy and Management at the University of South Florida's College of Public Health in Tampa FL. He has been involved in rural health primary care and public agency fiscal and managerial analysis and technical assistance for nearly 20 years. Bradham's research has focused on elderly health services since in Florida as well as cost effectiveness and efficiency in home health and rural primary care.

Self‐care and illness response to a recent medical event were examined based on a mailed questionnaire to a random sample of 416 adults in a frontier area in north‐central Idaho. A total of 494 questionnaires were returned (45% response rate), and 78 were eliminated. Self‐care behaviors were classified as: (1) waiting to see what would happen, (2) purchasing or taking a nonprescription medication, (3) taking a prescription medication that was on hand, (4) taking both a prescription and a nonprescription medication, (5) contacting a physician, and (6) going to a hospital. These six variables were classified into three intervention constructs of no intervention (waiting), informal intervention (self‐medicating), and formal intervention (contacting a health care professional). Fifty‐six percent of the respondents reported self‐medicating behaviors. Correlation analysis indicated that initial self‐care and illness response behaviors in this frontier area were generally appropriate. Three multiple discriminant models were tested to differentiate those people who waited, self‐medicated, and contacted formal providers from those who did not. A significant model could not discriminate between those who waited and those who did not. Models for self‐medicating and contacting formal providers correctly classified cases 60 to 70 percent of the time. The analyses indicate that self‐medicating was more likely to be reported by younger individuals, by those who lived further from the hospital, who perceived their health status to be better, who reported less satisfaction with community health care services, and that the self‐medicating was appropriate. Those respondents most likely to contact the physician reported a lower perceived health status, a higher level of appropriateness of seeking formal health care services, a perceived physician shortage as a serious community problem, greater use of a number of prescription medications in the previous two weeks, and reported living i

关键词：判别分析评价研究健康知识态度实践卫生服务研究/方法健康状况爱达荷/流行病学病人接受卫生保健的程度/统计学和数值数据问卷调查农村卫生/统计学和数值数据自我护理/心理学自我护理/统计学和数值数据自我护理/利用自我投药法/心理学自我投药法/统计学和数值数据自我投药法/利用社会经济因素成年人女(雌)性人类男(雄)性

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