PubMed · 14577101
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Paul Smith. 2003-10-09. Vacant expression.. https://pubmed.ncbi.nlm.nih.gov/14577101/
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BACKGROUND: Due to the complexity of health system reform in the post-conflict, post-disaster, and development settings, attempts to restructure health services are fraught with pitfalls that are often unanticipated because of inadequate preliminary assessments. Our proposed Integrated Multimodal Assessment - combining quantitative and qualitative methodologies - may provide a more robust mechanism for identifying programmatic priorities and critical barriers for appropriate and sustainable health system interventions. The purpose of this study is to describe this novel multimodal assessment using emergency medicine in post-conflict Serbia as a model. METHODS: Integrated quantitative and qualitative methodologies--system characterization and observation, focus group discussions, free-response questionnaires, and by-person factor analysis--were used to identify needs, problems, and potential barriers to the development of emergency medicine in Serbia. Participants included emergency and pre-hospital personnel from all emergency medical institutions in Belgrade. RESULTS: Demographic data indicate a loosely ordered network of part-time emergency departments supported by 24-hour pre-hospital services and an academic emergency center. Focus groups and questionnaires reveal significant impediments to delivery of care and suggest development priorities. By-person factor analysis subsequently divides respondents into distinctive attitudinal types, compares participant opinions, and identifies programmatic priorities. CONCLUSIONS: By combining quantitative and qualitative methodologies, our Integrated Multimodal Assessment identified critical needs and barriers to emergency medicine development in Serbia and may serve as a model for future health system assessments in post-conflict, post-disaster, and development settings.
The aim of this study was to determine the difference in oral health attitudes and behavior between male and female dental students at Jordan University of Science and Technology (JUST). A self-administered questionnaire based on a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) was distributed among 375 dental students. The response rate was 83.7% with 48% males and 52% females responding. Female students reported brushing their teeth more frequently than male students (P<0.001). Approximately 47% of the male students brushed their teeth less than twice daily compared to 21% of the female students. Also, female students believed in the necessity of using toothpaste during brushing more often than male students (P<0.01). On the other hand, smoking was much more frequent among males than among females (31% vs. 4%) (P<0.001). Male students indicated they had been smoking for longer periods of time than female students. This survey shows male students visit the dentist only when they have dental pain. While this was more than their female peers, it was not statistically significant (P= 0.056). In general the present study showed dental students in Jordan had poor oral health. Further research is needed to examine the students clinically for periodontal and caries conditions. Students should be encouraged to be a model for oral health for their families, friends, and patients.
BACKGROUND: Health differences between people from lower and higher social classes increase. The accessibility of the health care system is one of the multiple and complex causes. The Physician's perceptions, beliefs and attitudes towards the patient are in this context important determinants. OBJECTIVES: To explore the general practitioners' definition of poverty and their perception of the deprived patients' attitude towards health and health care, to get insight into the ways general practitioners deal with the problem of poverty and to present the proposals general practitioners make to improve health care for the deprived. METHOD: The study involved qualitative methodology using 21 semi-structured interviews. The interviews were recorded and transcribed verbatim. The transcripts were coded using Framework Analysis techniques. Interviews were undertaken with general practitioners in primary care, working in a deprived area in the city of Ghent. RESULTS: In the definition of poverty, three concepts can be identified: socioeconomic aspects, psychological and individual characteristics, and socio-cultural concepts. General practitioners adopt different types of approaches to deal with deprived patients in practice: adaptation of the doctor-patient communication, lowering of the financial threshold, referral to specialists and other health care professionals. CONCLUSION: Including the issue of poverty and poverty in the curriculum of the medical students and in the in-service training for practicing doctors could have a positive impact on their attitude towards this patient group. Further research is needed into the barriers in the accessibility of the health care system for the deprived, exploring qualitatively and quantitatively the experiences and the living conditions of deprived patients and the perceptions of health care providers.