Mental health literacy

وَقَالُواْ يَٰٓأَيُّهَا ٱلَّذِي نُزِّلَ عَلَيۡهِ ٱلذِّكۡرُ إِنَّكَ لَمَجۡنُونࣱ‏

They say, ‘Receiver of this Quran! You are definitely mad

قَالَ إِنَّ رَسُولَكُمُ ٱلَّذِيٓ أُرۡسِلَ إِلَيۡكُمۡ لَمَجۡنُونࣱ‏

Pharaoh said, ‘This messenger who has been sent to you is truly possessed.’

وَيَقُولُونَ أَئِنَّا لَتَارِكُوٓاْ ءَالِهَتِنَا لِشَاعِرࣲ مَّجۡنُونِۭ

and said, ‘Are we to forsake our gods for a mad poet?’

ثُمَّ تَوَلَّوۡاْ عَنۡهُ وَقَالُواْ مُعَلَّمࣱ مَّجۡنُونٌ

they turned their backs on him, saying, ‘He is tutored! He is possessed!’

فَتَوَلَّىٰ بِرُكۡنِهِۦ وَقَالَ سَٰحِرٌ أَوۡ مَجۡنُونࣱ‏

Pharaoh turned away with his supporters, saying, ‘This is a sorcerer, or maybe a madman,’

كَذَٰلِكَ مَآ أَتَى ٱلَّذِينَ مِن قَبۡلِهِم مِّن رَّسُولٍ إِلَّا قَالُواْ سَاحِرٌ أَوۡ مَجۡنُونٌ

Every previous people to whom a messenger was sent also said, ‘A sor-cerer, or maybe a madman!’

And they that is the disbelievers of Mecca say to the Prophet s ‘O you to whom the Remembrance the Qur’ān — as you claim — has been revealed lo! you are indeed possessed!

He said ‘Verily this messenger of yours sent to you is a madman!’

and would say ‘Are we to abandon our gods for a mad poet?’ that is for the sake of what Muhammad (s) says? as regards the hamzas in a-innā ‘are we’ the same applies as mentioned above.

And they say: "O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed! Verily, you are a madman (6)"Why do you not bring angels to us if you are of the truthful? (7)We do not send the angels down except with the truth, and in that case, they (the disbelievers) would have no respite (8)Verily, We, it is We Who revealed the Dhikr (i.e. the Qur'an) and surely We will guard it (from corruption)(9) The Accusation that the Prophet (ﷺ) was a Madman and Demands for Him to bring down Angels Allah tells us about the disbelief, arrogance and stubbornness of the disbelievers as reflected in their words: يَا أَيُّهَا الَّذِي نُزِّلَ عَلَيْهِ الذِّكْرُ (O you (Muhammad) to whom the Dhikr (the Qur'an) has been revealed!) i.e., the one who claims to receive it. إِنَّكَ لَمَجْنُونٌ (Verily, you are a mad man!) i.e., by your invitation to us to follow you and leave the way of our forefath

Fir'awn said: "And what is the Lord of Al-'Alamin (23)(Musa) said: "The Lord of the heavens and the earth, and all that is between them, if you seek to be convinced with certainty. (24)(Fir'awn) said to those around: "Do you not hear (what he says)? (25)(Musa) said: "Your Lord and the Lord of your ancient fathers! (26)(Fir'awn) said: "Verily, your Messenger who has been sent to you is a madman! (27)(Musa) said: "Lord of the east and the west, and all that is between them, if you did but understand! (28) Allah tells us about the disbelief, rebellion, oppression and denial of Fir'awn, as He says: وَمَا رَبُّ الْعَالَمِينَ ((Fir'awn said:) "And what is the Lord of the 'Alamin") This is because he used to say to his people: مَا عَلِمْتُ لَكُم مِّنْ إِلَٰهٍ غَيْرِي (I know not that you have a god other than me.)(28:38) فَاسْتَخَفَّ قَوْمَهُ فَأَطَاعُوهُ (Thus he fooled his people, and

And they will turn to one another and question one another (27)They will say: "It was you who used to come to us from the right side. (28)They will reply: "Nay, you yourselves were not believers. (29)"And we had no authority over you. Nay! But you were a transgressing people. (30)"So now the Word of our Lord has been justified against us, that we shall certainly taste (the torment). (31)"So we led you astray because we were ourselves astray. (32)Then verily, that Day, they will (all) share in the torment (33)Certainly, that is how We deal with the criminals (34)Truly, when it was said to them: "La ilaha illallah," they puffed themselves up with pride (35)And (they) said: "Are we going to abandon our gods for the sake of a mad poet? (36)Nay! he has come with the truth and he confirms the Messengers (37) The arguing of the Idolators on the Day of Resurrection Allah tells us that the disb

ولو كشف الغطاء لرأيت أكثر النفوس البشرية صرعى مع هذه الأرواح الخبيثة وهي في أسرها وقبضتها تسوقها حيث شاءت ولا يمكنها الامتناع عنها ولا مخالفتها وبها الصرع الأعظم الذي لا يفيق صاحبه إلا عند المفارقة والمعاينة فهناك يتحقق أنه كان هو المصروع حقيقة وبالله المستعان وعلاج هذا الصرع باقتران العقل الصحيح إلا الإيمان بما جاءت به الرسل وأن تكون الجنة والنار نصب عينه وقبلة قلبه ويستحرض أهل الدنيا وحلول المثولات والآفات بهم ووقوعها خلال ديارهم كمواقع القطر وهم صرعى لا يفيقون وما أشد أعداء هذا الصرع ولكن لما عمت البلية به بحيث ينظر الإنسان لا يرى إلا مصروعا لم يصر مستغربا ولا مستنكرا بل صار لكثرة المصروعين عين المستنكر المستغرب خلافة فإذا أراد الله بعبد حيرا أفاق من هذه الصرعة ونظر إلى أبناء الدنيا مصروعين حوله يمينا وشمالا على اختلاف طبقاتهم فمنهم من أطبق به الجنون ومنهم من يفيق أحيانا قليلة ويعود إلى جنونه ومنهم من يجن مرة ويفيق أخرى فإذا أفاق عمل عمل أهل الإفاقة والعقل ثم يعاوده الصرع فيقع في التخ

الثاني أن هذا باطل بصور كثيرة منها دخول الماء في العود والسحاب ودخول النار في الحديد ودخول الغذاء في جميع أجزاء البدن ودخول الجن في المصروع فالروح للطافتها لا يمتنع عليها مشابكة البدن والدخول في جميع أجزائه

فالعقل فن واحد وطريقه % أدرى فأرصد و الجنون فنون

هكذا ضعف الدين في قرون سالفة فكيف الظن بزمانك هذا وقد انتهى الأمر إلى أن مظهر الإنكار يستهدف لنسبته إلى الجنون فالأولى أن يشتغل الإنسان بنفسه ويسكت

وأما القسم الثاني، وهو المدح بسبب الجاه والمال، فالفرح بذلك، كالفرح بنبات الأرض الذي يصير عن قريب هشيما، ولا يفرح بذلك إلا من قل عقله، وإن كنت خاليا عن الصفة التي مدحت بها، ففرحك بالمدح غاية الجنون.

قالوا وكيف يمدح أمر يمنع القرار ويسلب المنام ويوله العقل ويحدث الجنون بل هو نفسه جنون كما قال بعض الحكماء الجنون فنون والعشق فن من فنونه كما قال بعض العشاق

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth.: Aim: Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age). Methods: Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study. Studies that reported three outcomes: kn

Is It Possible to "Find Space for Mental Health" in Young People? Effectiveness of a School-Based Mental Health Literacy Promotion Program.: Lack of knowledge regarding, and the stigma associated with, mental disorders have been identified as major obstacles for the promotion of mental health and early intervention. The present study aimed to evaluate the effectiveness of a school-based intervention program focused on the promotion of mental health literacy (MHL) in young people (“Finding Space for Mental Health”). A sample of 543 students (22 classes), aged between 12 and 14 years old, participated in the study. Each class of studen

Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.: Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experie

Adolescent health literacy and health behaviors: A systematic review.: Objectives: To systematically review and synthesize literature on the relationship between health literacy and health behaviors in adolescents. Methods: Searches in PsychInfo, PUBMED/MEDLINE, and Educational Resources Information Center (ERIC) were conducted. Studies were included if they reported original data on the relationship between health literacy and a health behavior in adolescents, were written in English, and the population did not have a chronic illness or disability. Results: Sevent

The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure.: Background: Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. Methods: The effect o

Workplace Interventions Targeting Mental Health Literacy, Stigma, Help-Seeking, and Help-Offering in Male-Dominated Industries: A Systematic Review.: Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell's relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace intervent

Social influence and motivation to change health behaviors among Mexican-origin adults: implications for diet and physical activity.

Purpose: To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Design: Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Setting: Families from an ongoing population-based cohort in Houston, Texas. Subjects: 475 adults from 161 Mexican-origin families. Out of 347 households contacted, 162 (47%) participated. Measures: Family health history, social networks, and motivation to change behaviors. Analysis: Two-level logistic regression modeling. Results: Having at least one network member who encourages one to eat more fruits and vegetables (p = .010) and to engage in regular physical activity (p = .046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encourager…

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Cancer awareness among adolescents in Britain: a cross-sectional study.

Background: Little is known about adolescents' cancer awareness and help-seeking behaviour in Britain. This study assessed adolescents': awareness of cancer symptoms, common cancers, and the relationship between cancer and age; anticipated delay and perceived barriers to seeking medical advice; and examined variation by age, gender, ethnicity and whether individuals knew someone with cancer. Methods: A survey was conducted using a modified paper version of the Cancer Awareness Measure (CAM). The sample included 478 adolescents (male: n = 250, 52.3%) aged 11-17 years old (mean = 13.8, SD = 1.24) recruited from four British schools between August and October 2011. Results: Adolescents' cancer awareness was low. Half of all adolescents did not know the most common childhood (51%) or teenage (49%) cancers and most (69%) believed cancer was unrelated to age. Awareness of cancer symptoms was s…

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A five-year prospective study of quality of life after colorectal cancer.

Purpose: Long-term (≥5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes. Method: A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis. Results: QOL improved over time (P < 0.01 for each measure); however, measures of psychological distress remained stable (P > 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, bei…

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Attitudes and decision making among women seeking abortions at one U.S. clinic.

Context: Various restrictions on abortion have been imposed under the pretense that women may be uninformed, undecided or coerced in regard to their decision to terminate a pregnancy. Understanding whether certain women are at risk of low confidence in their abortion decision is useful for providing client-centered care and allocating counseling time to women with the greatest needs. Methods: Data were abstracted from the precounseling needs assessment form and clinical intake form of 5,109 women who sought 5,387 abortions at one U.S. clinic in 2008. Multivariate logistic regression was used to analyze variables associated with women's high confidence in their abortion decision. Results: For 87% of the abortions sought, women had high confidence in their decision before receiving counseling. Certain variables were negatively associated with abortions' being sought by women with high conf…

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Health seeking behavior for cervical cancer in Ethiopia: a qualitative study.

Background: Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease. Methods: Focus group discussions were conducted with men, women, and community leaders in the rural settings of Jimma Zone southwest Ethiopia and in the capital city, Addis Ababa. Data were captured using voice recorders, and field notes were transcribed verbatim from the local languages into English language. Key categories and thematic frameworks were identified using the health belief model as a framework, and presented in narratives using the respondents own words as an illustration. Results: Participants had very low awareness of cervical cancer. However, once the symptoms were explained, participants had a high perception of the severity of the disease. The etiology of cer…

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Barriers and motivators affecting tuberculosis infection control practices of Russian health care workers.

Setting: Five in-patient and out-patient tuberculosis (TB) care facilities in two regions of Russia. Objective: To identify barriers and motivators to the use of infection control measures among Russian TB health care workers. Design: In this qualitative study, a convenience sample of 96 health care workers (HCWs) was used to generate 15 homogeneous focus groups, consisting of physicians, nurses, and laboratory or support staff. Results: Barriers and motivators related to knowledge, attitudes and beliefs, and practices were identified. The three main barriers were 1) knowledge deficits, including the belief that TB was transmitted by dust, linens and eating utensils; 2) negative attitudes related to the discomfort of respirators; and 3) practices with respect to quality and care of respirators. Education and training, fear of infecting loved ones, and fear of punishment were the main mot…

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Examining the pathways linking lower socioeconomic status and advanced melanoma.

Background: Low socioeconomic status (SES) is associated with more advanced melanoma at diagnosis and decreased survival. Exploring the pathways linking lower SES and thicker melanoma will help guide public and professional strategies to reduce deaths. Methods: The authors surveyed 566 newly diagnosed patients at Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System, and University of Michigan. SES was assessed by education level (high school/general education degree or less [HS], associate/technical school degree, or ≥college graduate). All data was obtained by self-report among patients within three months of their diagnosis. Results: HS-educated individuals were significantly more likely than college graduates to believe that melanoma was not very serious (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.79-4.71) and were less likely to know the asymm…

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Capitals and capabilities: linking structure and agency to reduce health inequalities.

While empirical evidence continues to show that low socio-economic position is associated with less likely chances of being in good health, our understanding of why this is so remains less than clear. In this paper we examine the theoretical foundations for a structure-agency approach to the reduction of social inequalities in health. We use Max Weber's work on lifestyles to provide the explanation for the dualism between life chances (structure) and choice-based life conduct (agency). For explaining how the unequal distribution of material and non-material resources leads to the reproduction of unequal life chances and limitations of choice in contemporary societies, we apply Pierre Bourdieu's theory on capital interaction and habitus. We find, however, that Bourdieu's habitus concept is insufficient with regard to the role of agency for structural change and therefore does not readily …

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Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: four quasi-experimental single-subject studies.

The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a total of 63 consultations with patients. The tailored intervention included individual goal setting, skills training, and feedback on performance. The primary outcome was the nu…

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Spirituality and spiritual caring: nurses' perspectives and practice in palliative and acute care environments.

Aims and objectives: Identify and compare spiritual caring practice by palliative care and acute care registered nurses (RNs), determine any correlation between nurses' spiritual perspective and their spiritual caring, and to investigate perceived barriers to spiritual caring. Background: Over the past decade there has been growing interest in spiritual caring in nursing. Professional nursing bodies have proposed spirituality and spiritual caring as an integral component of holistic nursing. Design: Cross sectional study. Methods: Palliative care RNs (n = 42) from one community palliative care service and three hospices, and acute care RNs (n = 50) from three major acute care hospitals all in metropolitan Sydney, Australia completed a research questionnaire. Two validated tools and a demographic survey were used to collect data. These tools measured spiritual perspectives including salie…

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Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

Background: Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. Method: This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Results: I…

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Acceptance of dying: a discourse analysis of palliative care literature.

The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its "opposite", the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term "acceptance" of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words "accept or acceptance" with the subject headings "terminal care or palliative care or hospice care", and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare work…

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Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory.

Background: Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT) to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods: We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews) to explore the views of managers, care staff, catering staff, and domestic st…

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Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme.

Aim: To explore whether changes in parenting self-efficacy after attending a parenting programme are related to changes in parenting stress and child behaviour. Background: Adverse parenting is a risk factor in the development of a range of health and behavioural problems in childhood and is predictive of poor adult outcomes. Strategies for supporting parents are recognised as an effective way to improve the health, well-being and development of children. Parenting is influenced by many factors including the behaviour and characteristics of the child, the health and psychological well-being of the parent and the contextual influences of stress and support. Parenting difficulties are a major source of stress for parents, and parenting self-efficacy has been shown to be an important buffer against parenting stress. Methods: In all, 63 parents who had a child under the age of 10 years took …

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Responses to mental health stigma questions: the importance of social desirability and data collection method.

Objective: To evaluate the impact on the general public of England's Time to Change program to reduce mental health-related stigma and discrimination using newly developed measures of knowledge and intended behaviour regarding people with mental health problems, and an established attitudes scale, and to investigate whether social desirability affects responses to the new measures and test whether this varies according to data collection method. Method: The Mental Health Knowledge Schedule (MAKS) and Reported and Intended Behaviour Scale (RIBS) were administered together with the 13-item version of the Marlowe-Crowne Social Desirability Scale to 2 samples (each n = 196) drawn from the Time to Change mass media campaign target group; one group was interviewed face to face, while the other completed the measures as an online survey. Results: After controlling for other covariates, interact…

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Addressing Tobacco Through Organizational Change (ATTOC) in residential addiction treatment settings.

Background: Smoking prevalence among persons in addiction treatment is 3-4 times higher than in the general population. However, treatment programs often report organizational barriers to providing tobacco-related services. This study assessed the effectiveness of a six month organizational change intervention, Addressing Tobacco Through Organizational Change (ATTOC), to improve how programs address tobacco dependence. Methods: The ATTOC intervention, implemented in three residential treatment programs, included consultation, staff training, policy development, leadership support and access to nicotine replacement therapy (NRT) medication. Program staff and clients were surveyed at pre- and post-intervention, and at 6 month follow-up. The staff survey measured knowledge of the hazards of smoking, attitudes about and barriers to treating smoking, counselor self-efficacy in providing such …

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Understanding barriers to Malaysian women with breast cancer seeking help.

Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time …

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An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices.

Background: The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices. Methods: A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia. Results: Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum scor…

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Internet-based psychoeducation for bipolar disorder: a qualitative analysis of feasibility, acceptability and impact.

Background: In a recent exploratory randomised trial we found that a novel, internet-based psychoeducation programme for bipolar disorder (Beating Bipolar) was relatively easy to deliver and had a modest effect on psychological quality of life. We sought to explore the experiences of participants with respect to feasibility, acceptability and impact of Beating Bipolar. Methods: Participants were invited to take part in a semi-structured interview. Thematic analysis techniques were employed; to explore and describe participants' experiences, the data were analysed for emerging themes which were identified and coded. Results: The programme was feasible to deliver and acceptable to participants where they felt comfortable using a computer. It was found to impact upon insight into illness, health behaviour, personal routines and positive attitudes towards medication. Many participants regard…

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Using psychological theory to inform methods to optimize the implementation of a hand hygiene intervention.

Background: Careful hand hygiene (HH) is the single most important factor in preventing the transmission of infections to patients, but compliance is difficult to achieve and maintain. A lack of understanding of the processes involved in changing staff behaviour may contribute to the failure to achieve success. The purpose of this study was to identify nurses' and administrators' perceived barriers and facilitators to current HH practices and the implementation of a new electronic monitoring technology for HH. Methods: Ten key informant interviews (three administrators and seven nurses) were conducted to explore barriers and facilitators related to HH and the impact of the new technology on outcomes. The semi structured interviews were based on the Theoretical Domains Framework by Michie et al. and conducted prior to intervention implementation. Data were explored using an inductive qual…

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A mixed-method assessment of beliefs and practice around breast cancer in Ethiopia: implications for public health programming and cancer control.

A large proportion of breast cancer patients in Ethiopia present for biomedical care too late, or not at all, resulting in high mortality. This study was conducted to better learn of beliefs and practices among patients accessing breast cancer services in a large referral centre in Ethiopia. Using a mixed-method design, we interviewed 69 breast cancer patients presenting for care at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, about their beliefs, experiences and perspectives on breast cancer. Awareness of breast cancer is low in Ethiopia and even among those who are aware of the disease, a sense of hopelessness and fatalism is common. Early signs/symptoms are frequently ignored and patients often first present to traditional healers. Breast cancer is perceived as being caused typically from humoral anomalies or difficulties resulting from breast feeding, and study participants indic…

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Norms and practices within marriage which shape gender roles, HIV/AIDS risk and risk reduction strategies in Cabo Delgado, Mozambique.

Despite increasing HIV/AIDS rates among married individuals, minimal research has been conducted on how men and women respond to risk in a marriage. This paper examines strategies used by married individuals to combat HIV/AIDS risk against prevailing gender norms. Qualitative data were gathered in four villages of Cabo Delgado province, Mozambique. Group discussions were held with 160 men and women to explore gender norms, HIV/AIDS knowledge and risk determinants. From the group discussions, 29 individuals were selected for further in-depth interviews to explore relationships between gender norms and risk reduction efforts within marriages. Findings illustrate how infidelity and social limitations placed on condom use not only increase HIV/AIDS risk but also entrench gender disparities. Although power differences between genders can make it difficult to negotiate safe sex, men and women …

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Predictors of non-adherence to aromatase inhibitors among commercially insured women with breast cancer.

The purpose of this study is to investigate 1-year adherence rates to aromatase inhibitors (AI) and to determine risk factors for non-adherence among commercially insured post-menopausal breast cancer patients. A retrospective cohort of 13,593 commercially insured breast cancer patients with a prescription claim for an AI therapy (exemestane, anastrozole, and letrozole) in 2006 were identified using the MarketScan Commercial Claims and Encounters Database. Adherence was calculated by the medication possession ratio (MPR) for a 1-year period following the initial claim in 2006. The main outcome variable was non-adherence (<80% MPR) to AI therapy. Multivariate logistic regression was used to determine predictors of non-adherence. Over a 1-year period, 23% of patients were non-adherent with their AI therapy. AI non-adherence was associated with younger age, out-of-pocket costs ≥$30 per AI p…

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"Macho men" and preventive health care: implications for older men in different social classes.

The gender paradox in mortality--where men die earlier than women despite having more socioeconomic resources--may be partly explained by men's lower levels of preventive health care. Stereotypical notions of masculinity reduce preventive health care; however, the relationship between masculinity, socioeconomic status (SES), and preventive health care is unknown. Using the Wisconsin Longitudinal Study, the authors conduct a population-based assessment of masculinity beliefs and preventive health care, including whether these relationships vary by SES. The results show that men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care. Furthermore, in contrast to the well-established SES gradient in health, men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive…

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Attributions about cause of illness in chronic obstructive pulmonary disease.

Objective: Patients' beliefs about the causes of their illness have been associated with emotional adjustment and behavioral outcomes in several medical conditions; however, few studies have examined illness attributions among patients with chronic obstructive pulmonary disease (COPD). In the current study, patterns of patients' causal attributions for COPD were identified and examined in relation to health behaviors and symptoms. Method: Three-hundred and ninety-four patients with COPD and >10 pack year history of smoking completed a self-report questionnaire that included the Illness Perception Questionnaire-Revised (IPQ-R). Results: A factor analysis of the IPQ-R cause items using principal axis factoring yielded four individual items (i.e., smoking, heredity, pollution, and personal behavior) and one large factor that was primarily driven by psychological attributions. Ninety-three p…

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