Whether and how people reach care.
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1026 to 1050 of 2,047Help-seeking behaviour among people living with chronic hip or knee pain in the community.
Background: A large proportion of people living with hip or knee pain do not consult health care professionals. Pain severity is often believed to be the main reason for help seeking in this population; however the evidence for this is contradictory. This study explores the importance of several potential risk factors on help seeking across different practitioner groups, among adults living with chronic hip or knee pain in a large community sample.
Methods: Health care utilization, defined as having seen a family doctor (GP) during the past 12 months; or an allied health professional (AHP) or alternative therapist during the past 3 months, was assessed in a community based sample aged 35 or over and reporting pain in hip or knee. Adjusted odds ratios were determined for social deprivation, rurality, pain severity, mobility, anxiety/depression, co-morbidities, and body mass index.
Results…
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Stress and help-seeking for drought-stricken citrus growers in the Riverland of South Australia.
Objective: To explore the psychological impact of a problematic industrial climate for citrus growers, their help-seeking behaviour and perspectives on ways to encourage better use of rural mental health services.
Design: Thematic analysis of in-depth interviews.
Setting: The Riverland of South Australia.
Participants: Sixteen citrus growers (12 male, 4 female) from eight Riverland towns.
Main outcome measures: Citrus growers' perceived factors relating to psychological stress, coping behaviours, impact of stress on well-being, help-seeking behaviours, barriers to help-seeking and ways to encourage better use of rural mental health services.
Results: Work-related stresses grouped under broad themes, including 'Uncontrollable events', 'Financial hardship' and 'Pressure', had negative effects on participants' well-being. Furthermore, it was found that significant difficulties arise because…
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"Why doesn't she seek help for partner abuse?" An exploratory study with South Asian immigrant women.
This study explores why South Asian immigrant women with experiences of partner abuse delay seeking help from professionals. Three focus groups were conducted in Hindi language with South Asian immigrant women in Toronto. Twenty-two women participated with a mean age of 46 years (range 29-68 years). Thematic analysis was conducted on the transcribed data using constant comparison techniques within and across the groups. We found that three major themes emerged from the discussions: reasons for delayed help-seeking, turning points and talking to professionals. Women expressed delaying help-seeking to the point when "Pani sar se guzar jata he" (water crosses over your head). Their dominant reasons for delayed help-seeking were social stigma, rigid gender roles, marriage obligations, expected silence, loss of social support after migration and limited knowledge about available resources and…
matched on Patient Acceptance of Health Care (mesh), help-seeking (text)
Characteristics of help-seeking behaviour in subjects with subjective memory complaints at a memory clinic: a case-control study.
Objective: Memory complaints in the absence of objective test impairments are common. Only a subset of these subjects seeks medical attention for these complaints. The aim of the present study was to investigate which factors determine why people with subjective memory complaints (SMC) seek medical attention.
Methods: Thirty-three cases with SMC from a memory clinic were compared to 85 control subjects with SMC from a population-based study who did not seek help for their complaints. We investigated whether cases differed from controls with respect to the following: depressive and anxiety symptoms (SCL-90), extraversion and neuroticism (EPQ), meta-memory (MIA), quality of life (SF-36), changes in memory and daily functioning according to a relative (DECO), life-changing events, and a family history of dementia.
Results: Cases with SMC who seek medical attention, scored lower on memory se…
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Exploring Mexican-origin intimate partner abuse survivors' help-seeking within their sociocultural contexts.
Women's responses to partner abuse are shaped by their particular sociocultural contexts. In this study, quantitative data were collected from 75 Mexican-origin women who survived intimate partner abuse, to identify variables associated with help-seeking to survive relationship abuse. Help-seeking was defined as use of formal (e.g., shelter) and informal (e.g., family) sources. Variables included two cultural variables: machismo (i.e., adherence to traditional gender roles) and familismo (i.e., valuing family cohesion and reciprocity), and four sociostructural variables: income, education, English proficiency, and immigrant status. Results indicated participants with higher levels of familismo sought informal help more frequently than those with lower levels. Women with grade school education, no English proficiency, and undocumented status sought formal help less frequently than those n…
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Men, masculine identities, and health care utilisation.
Seeking medical help early is critical for recovery, yet evidence indicates that men do not utilise general practitioner services as often as women. This paper draws on Connell's (1995) theory of hegemonic masculinity to critically examine how men's under-utilisation of medical services may be influenced by the social construction of masculine identities. Interviews with seven older rural men about their help-seeking behaviour, used a movie extract and hypothetical scenarios to stimulate discussion. Transcribed data were analysed using discourse analysis, which showed that in this particular social context, the men faced a dilemma when identifying with two conflicting subject positions: the virtuous regular health care user, and the masculine infrequent user of health care services. They solved this dilemma by positioning women as frequent and trivial users of health care and themselves …
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Women's management of menstrual symptoms: findings from a postal survey and qualitative interviews.
This paper draws on postal questionnaire and qualitative interview data to investigate women's experiences of and responses to menstrual symptoms. Respondents were drawn from general practices in the Lothian region of Scotland. They described a range of strategies to manage menstrual symptoms, learnt both from personal experience and discussions with others. While most women had spoken to others about periods, this more often related to matters such as changes with age, or pain management, whereas heaviness of blood loss was not usually a subject for discussion. When asked about formal help-seeking women described it as a step reluctantly taken, only if attempts to self manage failed, and that often it was opportunistic, occurring when consulting for something else. It was apparent that women thought of menstrual symptoms, even when felt to be problematic, as 'part and parcel' of female …
matched on Health Services Accessibility (mesh), help-seeking (text)
Factors affecting home delivery in rural Tanzania.
Background: Studies of factors affecting place of delivery have rarely considered the influence of gender roles and relations within the household. This study combines an understanding of gender issues relating to health and help-seeking behaviour with epidemiological knowledge concerning place of delivery.
Methods: In-depth interviews, focus group discussions and participant observation were used to explore determinants of home delivery in southern Tanzania. Quantitative data were collected in a cross-sectional survey of 21,600 randomly chosen households.
Results: Issues of risk and vulnerability, such as lack of money, lack of transport, sudden onset of labour, short labour, staff attitudes, lack of privacy, tradition and cultures and the pattern of decision-making power within the household were perceived as key determinants of the place of delivery. More than 9000 women were intervie…
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"Getting me back on track": the role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care.
This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/AIDS (PLWHA). In-depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by (1) their level of acceptance of being diagnosed with HIV, (2) their ability to cope with substance use, mental illness, and stigma, (3) their health care provider relationships, (4) the presence of external support systems, and (5) their ability to …
matched on Patient Acceptance of Health Care (mesh), barriers to care (text)
The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking.
Objectives: This study evaluated the associated comorbidities and patient satisfaction with treatment options for premature ejaculation (PE), a common sexual dysfunction.
Methods: A comprehensive, Internet-based survey (the PE Prevalence and Attitudes [PEPA] survey) was conducted among men ages 18-70 in the United States, Germany, and Italy (n=12,133). Men were classified as having PE based on self-report of low or absent control over ejaculation, resulting in distress for them or their sexual partner or both.
Results: The prevalence of PE was 22.7% (24.0% in the United States, 20.3% in Germany, and 20.0% in Italy) and did not vary significantly with age among men over age 24 yr. Men with PE were more likely to self-report other sexual dysfunctions (e.g., anorgasmia, low libido, erectile dysfunction) and psychological disturbances (e.g., depression, anxiety, excessive stress) than men wi…
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Prevalence and correlates of personality disorder in Great Britain.
Background: Epidemiological data on personality disorders, comorbidity and associated use of services are essential for health service policy.
Aims: To measure the prevalence and correlates of personality disorder in a representative community sample.
Method: The Structured Clinical Interview for DSM-IVAxis II disorders was used to measure personality disorder in 626 persons aged 16-74 years in households in England, Scotland and Wales, in a two-phase survey.
Results: The weighted prevalence of personality disorder was 4.4% (95% CI 2.9-6.7). Rates were highest among men, separated and unemployed participants in urban locations. High use of healthcare services was confounded by comorbid mental disorder and substance misuse. Cluster B disorders were associated with early institutional care and criminality.
Conclusions: Personality disorder is common in the community, especially in urban ar…
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Erectile dysfunction and premature ejaculation are the most frequently self-reported sexual concerns: profiles of 9,536 men calling a helpline.
Objectives: To describe the range of sexual problems, as reported by men calling a help-line and to investigate factors associated with help seeking behaviour.
Methods: The study included all calls between 1999 and 2004. The information used for analysis comprised caller's demographic characteristics, the sexual problem reported, previous doctor contacts, coexisting physical and mental health problems.
Results: Erectile dysfunction (ED) and premature ejaculation (PE) were the most frequently reported problems (57 and 19.2% respectively). ED-reporting callers were older (OR 0.63 for the ages of 50-59 yrs), with co-morbidities (OR 1.75) and in stable relationship (OR 0.46), while PE-reporting callers were younger (OR 5.83 for the ages of 20-29 yrs), relatively healthy and more likely single (OR 2.62 and OR 2.92 respectively). Type and duration of sexual concern, age, coexisting health prob…
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Patient delay in oral cancer: a qualitative study of patients' experiences.
Up to 30% of patients delay seeking the advice of a healthcare professional after self-discovery of symptom(s) of oral cancer. Reasons for this patient delay are poorly understood. The aim of the present study was to explore patients' initial experiences and reactions to developing symptoms of oral cancer, and to identify factors influencing their decision to consult a health care professional. In-depth semi-structured interviews were conducted with 17 consecutive patients who had received a diagnosis of oral squamous cell carcinoma, but had yet to start treatment. Participants were asked about their beliefs about their symptoms over the course of the disease and their decision to seek help. The tape-recorded interviews were transcribed verbatim and analysed using 'Framework analysis'. Oral symptoms were rarely attributed to cancer and were frequently interpreted as minor oral conditions…
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Prevalence of DSM-IV disorders and attendant help-seeking in 2 American Indian reservation populations.
Background: The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) estimated the mental health burden and associated help-seeking in select American Indian reservation communities.
Objective: To determine the lifetime and 12-month prevalence of common DSM-IV disorders, their demographic correlates, and patterns of help-seeking in 2 culturally distinct American Indian reservation communities in the Southwest and Northern Plains.
Design: Completed between 1997 and 2000, a cross-sectional probability sample survey.
Setting: General community.
Participants: Three thousand eighty-four (Southwest = 1446 and Northern Plains = 1638) members, aged 15-54 years, of 2 tribal groups living on or near their home reservations were randomly sampled from the tribal rolls. Response rates were 73.7% and 76.8% for the Southwest and Northern Plain…
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Prevalence of mental illness among homeless men in the community--approach to a full census in a southern German university town.
Aim: Within the framework of a study of homeless men in the university town of Tubingen in southern Germany, the prevalence of psychiatric disorders and the existing help-seeking behavior, among other things, were to be recorded.
Method: A total of 151 men belonging to the target group were identified; 91 of them participated in the study. Besides the psychiatric diagnosis, the registered data included psychopathology, cognitive capacity, social functioning and satisfaction with life, as well as social history and case history.
Results: Of the probands, 73% were suffering from at least one ongoing psychiatric disorder (diagnosed according to ICD-10 and DSM-IV), primarily alcohol dependence (74%) and drug dependence (34 %), 26% were suffering from an anxiety disorder, 15% from an affective disorder, and 11 % from a disorder of the schizophrenic spectrum. Comorbidity was diagnosed in 67%. …
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The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up.
The McLean Study of Adult Development (MSAD) began 12 years ago. It is the first NIMH-funded prospective study of the course and outcome of borderline personality disorder (BPD). After careful analysis of the first six years of follow-up, 5 main findings concerning the symptomatic and psychosocial course of BPD have emerged from this study. The first finding is that remissions are far more common than previously recognized (about 74%). The second is that these remissions are quite stable and thus, recurrences are quite rare (about 6%). The third finding is that completed suicides are far more rare than anticipated (about 4% vs. 10%). The fourth finding is that a "complex" model of borderline psychopathology best describes BPD. In this model, some symptoms resolve relatively quickly, are the best markers for the disorder, and are often the immediate reason for needing costly forms of trea…
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Semrau M, Evans-Lacko S, Alem A, Ayuso-Mateos JL, Chisholm D, Gureje O, Hanlon C, Jordans M, Kigozi F, Lempp H, Lund C, Petersen I, Shidhaye R, Thornicroft G (2015)editorial or commentMEDLINE-indexed journal, not yet read by usBMC medicine151 citations Strengthening mental health systems in low- and middle-income countries: the Emerald programme.
There is a large treatment gap for mental health care in low- and middle-income countries (LMICs), with the majority of people with mental, neurological, and substance use (MNS) disorders receiving no or inadequate care. Health system factors are known to play a crucial role in determining the coverage and effectiveness of health service interventions, but the study of mental health systems in LMICs has been neglected. The 'Emerging mental health systems in LMICs' (Emerald) programme aims to improve outcomes of people with MNS disorders in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda) by generating evidence and capacity to enhance health system performance in delivering mental health care. A mixed-methods approach is being applied to generate evidence on: adequate, fair, and sustainable resourcing for mental health (health system inputs); integrated provision of m…
matched on Mental Health Services (mesh), treatment gap (text)
Treatment gap in common mental disorders: the Singapore perspective.
Aims: The problem of wide treatment gaps in mental disorders is endemic world wide. The study aims to establish the treatment gap of common mental disorders in Singapore.
Methods: A national sample of 6616 persons aged 18 years and above was surveyed with the World Mental Health Composite International Diagnostic Interview in which for each diagnostic module, respondents were asked a series of questions regarding treatment contact.
Results: Treatment gap varied considerably between disorders; alcohol abuse had the largest treatment gap (96.2%), followed by obsessive compulsive disorder (89.8%) and alcohol dependence (88.3%). The disorder for which people were most likely to seek help was major depressive disorder. Women with dysthmia were more likely than men to seek help but this help seeking behavior was reversed among those with alcohol abuse and dependence. Age of onset was significa…
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The new lithium clinic.
Until the early 1950s, no effective pharmacological treatment existed for bipolar affective disorder. By the early 1960s, specialty clinics were being set up to dispense lithium carbonate to bipolar patients. By the late 1980s, a new body of knowledge was influencing the perception of bipolar disorder and how the disease should be treated. The authors' lithium clinic from 1974 has grown and evolved from a lithium blood level monitoring model into a comprehensive care model with polypharmacy, psychoeducation, rehabilitation, cognitive therapy, social rhythm therapy, and employment counseling as well as a staff of 2 part-time psychiatrists and 1 clinical psychologist. This service delivery model may benefit both treatment and research in bipolar disorder. The evolution of psychopharmacological and psychosocial knowledge in treating bipolar illness has been integrated into our clinic. Case …
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Attitudes toward mental health and mental health care among custodial grandparents.
Objective: Two-hundred thirty-nine grandparents who were raising their grandchildren were surveyed regarding their attitudes toward mental health and mental health care as well as their use of mental health services, each twice over a one-year time frame. Methods: Mental health attitudes were assessed utilizing self-report scales assessing openness to seeking help, biases regarding mental health and mental health professionals, and breadth regarding beliefs about the origins of mental/emotional distress. Results: Findings suggested that grandparent caregivers were generally positive regarding their willingness to seek mental health care, biases regarding mental health professionals, and beliefs about the origins of emotional distress. Factors that predicted mental health attitudes reflected grandparent personal characteristics, aspects of caregiving, and sample demographics. There was a …
matched on Mental Health Services (mesh), Attitude to Health (mesh)
Perceptions of postnatal depression and health care needs in a South African sample: the "mental" in maternal health care.
Background: Maternal mental health care is a neglected area in low and middle income countries (LAMIC) such as South Africa, where maternal and child health care priorities are focused on reducing maternal and infant mortality and promoting infant physical health. In the context of a paucity of mental health specialists, the aim of this study was to understand the explanatory models of illness held by women with maternal depression with the view to informing the development of an appropriate counselling intervention using a task sharing approach.
Methods: Twenty semi-structured qualitative interviews were conducted with mothers from a poor socio-economic area who were diagnosed with depression at the time of attending a primary health care facility. Follow-up interviews were conducted with 10 participants in their homes.
Results: Dimensions of poverty, particularly food and financial ins…
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Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental health services.
Purpose: This study investigates attitudes and social distance towards the mentally ill in a post-conflict, low-income country.
Methods: A cross-sectional community survey (n = 1,200) was conducted in South Sudan. Associations between various sociodemographic variables and attitudes toward/social distance from the mentally ill were investigated.
Results: The regression analysis showed that lower levels of education were positively associated with social distance, and Christian or Muslim beliefs, compared with traditional beliefs, were negatively associated with social distance. Familiarity with mental illness or psychological distress was not significantly associated with social distance. Participants who endorsed community-oriented attitudes (rather than hospital/drug-oriented attitudes) about health care for the mentally ill were more likely show a decreased social distance. Participan…
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Hope and improvements in mental health service providers' recovery attitudes following training.
Background: Service providers' attitudes towards recovery can improve with formal training. However, it is unclear whether improvements depend on dispositional hope.
Aims: To determine whether attitudinal improvements following formal recovery training vary depending on participants' dispositional hope.
Method: One hundred and three providers attended formal recovery training and completed measures of recovery knowledge, attitudes, hopefulness and optimism.
Results: Training improved providers' recovery knowledge, attitudes, hopefulness and optimism. Providers with both high and low dispositional hope achieved similar gains.
Conclusions: Attitudinal improvements following formal recovery training were not dependent on baseline levels of dispositional hope. Institutions committed to recovery-oriented care should consider utilizing formal training.
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Negative attitudes toward help seeking for mental illness in 2 population-based surveys from the United States and Canada.
Objectives: To determine the prevalence and sociodemographic correlates of negative attitudes toward help seeking for mental illness among the general population in the United States and Ontario.
Methods: Two contemporaneous population-based surveys (aged 15 to 54 years) were analyzed: the US National Comorbidity Survey (NCS) (n = 5877) and the Ontario Health Survey (OHS) (n = 6902). Multiple logistic regression analyses were used to examine the correlates of a derived negative attitudes composite variable obtained from questions assessing probability, comfort, and embarrassment related to help seeking for mental illness.
Results: Negative attitudes toward help seeking for mental illness were prevalent in both countries. Fifteen percent of OHS and 20% of NCS respondents stated they probably or definitely would not seek treatment if they had serious emotional problems. Almost one-half of …
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Bernstein KS (2007)MEDLINE-indexed journal, not yet read by usJournal of transcultural nursing : official journal of the Transcultural Nursing Society17 citations Mental health issues among urban Korean American immigrants.
Korean immigrants' perception and understanding of mental health and illness were surveyed during four monthly mental health seminars in New York City. In all, 86 Korean immigrants attended the seminars and 34 completed the survey. The seminar participants were primarily financially stable Korean women who were married, educated, and had lived in America more than 10 years. All seminar leaders were Korean immigrants who were working in the mental health field and/or educational setting. Most of the participants acknowledged the need for mental health services but did not seek professional help and coped with the stressors of immigrant life by endurance, patience, and religion. Feedback from seminar leaders noted the following: (a) greater seminar attendance than anticipated, (b) participants' openness to their mental illness issues, (c) need for tailored mental health program for Koreans…
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