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PubMed2005

Access to appropriate information on HIV is important in maximizing the acceptance of the antenatal HIV antibody test.

The universal HIV antibody testing programme was implemented in Hong Kong in September 2001. A survey on acceptance of the test was conducted in the territory's maternal and child health centres in a two-month period. The response rate was 98.2% and 2,669 valid questionnaires were analysed. Seventy per cent (n=1,825) of the respondents indicated their acceptance of the test. A significant association was noted between clients' acceptance and access to HIV information (adjusted odds ratio (OR)=10.45, 95% confidence interval (CI)=6.33-17.26) by means of posters, pamphlets, videos and group talks. Perceived benefits and health care workers' recommendation were the main reported reasons for acceptance, whereas no or low perceived susceptibility was the main reason for refusal. Acceptance was also positively correlated with level of education (adjusted OR=3.99, 95% CI=2.15-7.43) and HIV knowledge (adjusted OR=3.61, 95% CI=2.19-5.93). A high uptake rate (99.6%) reflects that most had the test done eventually despite some initial uncertainty. It is concluded that access to appropriate HIV information was important to maximize the acceptance of the programme.

Adolescent↗
PubMed2000

Predictors of recommendation and acceptance of intrapartum epidural analgesia.

UNLABELLED: We conducted this prospective study to characterize the obstetric and sociodemographic variables that predict physicians' recommendations and patients' acceptance of intrapartum epidural analgesia. The study population consisted of 447 consecutive, low-risk parturients in early active labor. Epidural analgesia was recommended to 393 patients (87.9%), however only 164 (41.7%) consented to receive it. A multiple logistic regression analysis demonstrated that the severity of pain, as assessed by the medical staff (odds ratio [OR] = 1.5, 95% confidence interval [CI] 1.13, 1.93), low parity (OR = 0.57, 95% CI 0.44, 0.74), and low maternal age (OR = 0.89, 95% CI 0.79, 0.99) were significant factors affecting recommendations of epidural analgesia. In a multivariate analysis, severity of subjective pain (OR = 1.39, 95% CI 1.16, 1.68), low parity (OR = 0.80, 95% CI 0.73, 0.99), high education (OR = 90.09, 95% CI 27.02,257.06), and the patients' being secular compared with religious (OR = 2.14, 95% CI 1.08,4.21) were found to be independent predictors of acceptance of epidural analgesia. There are differences between patients offered and those not offered epidural analgesia and between parturients who accept and those who do not accept this analgesia. IMPLICATIONS: We studied the factors that influence the recommendation of epidural analgesia by obstetricians, as well as its acceptance by the laboring patients at a university hospital in Israel. Epidural analgesia was recommended more often to low parity, younger women exhibiting more pain. Parturients who perceived greater pain were more secular, had low parity, and had a higher level of education were more likely to accept it.

Adult↗
PubMed2001

Acceptance of hepatitis B vaccination among adult patients with sexually transmitted diseases.

BACKGROUND: Sexually transmitted disease (STD) clinic patients are at risk for hepatitis B virus infection, but have been relatively neglected in terms of hepatitis B virus (HBV) immunization. Acceptance of HBV vaccine among patients attending an STD clinic was examined. GOAL: To evaluate potential predictors of HBV vaccine acceptance. STUDY DESIGN: In this study, 99 patients attending an STD clinic completed a brief questionnaire that addressed knowledge of STD and vaccines as well as sexual behavior. After the questionnaire, each patient was offered HBV vaccine, then interviewed to assess reasons for acceptance or refusal. RESULTS: Among the patients in this study, 23% accepted the vaccine and 11% reported prior vaccination. Acceptors were younger, had less education, and used condoms less frequently than those who refused vaccination. The reasons given for acceptance or rejection typically involved health beliefs related to infection or vaccination. CONCLUSION: The findings indicate an unacceptably low rate of HBV vaccine acceptance in a group at high risk for infection. However, some of the reasons for refusal may be modifiable through brief, targeted interventions.

Adolescent↗
PubMed2005

Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda.

OBJECTIVE: To assess the acceptance of voluntary HIV counseling and testing (VCT) and the effects of VCT on sexual risk behavior and HIV acquisition in Rakai, Uganda. METHODS: In a rural cohort, 10 694 consenting adults were interviewed, provided blood for HIV testing and were offered free VCT by community resident counselors. The proportions receiving VCT and the adjusted risk ratio (adj. RR) of VCT acceptance were estimated by log binomial regression. Risk behaviors and HIV incidence per 100 person-years (PY) in HIV-negative acceptors and non-acceptors of VCT were assessed prospectively. RESULTS: Although 93% initially requested HIV results, 62.2% subsequently accepted VCT. VCT acceptance was lower among persons with no prior VCT [Adj. RR = 0.88; 95% confidence interval (CI), 0.85-0.90], individuals with primary education (adj. RR = 0.94; 95% CI, 0.90-0.99) or higher (adj. RR = 0.91; 95% CI, 0.87-0.97), individuals who were HIV-positive (adj. RR = 0.72; 95% CI, 0.68-0.76), and persons reporting condom use in the past 6 months (inconsistent users, adj. RR = 0.95; 95% CI, 0.90-0.99; consistent users, adj. RR = 0.88; 95% CI, 0.82-0.95). VCT acceptance was higher among the currently married (adj. RR = 1.14; 95% CI, 1.08-1.20) and previously married (adj. RR = 1.11; 95% CI, 1.04-1.18). Receipt of results was not significantly associated with age, gender, and self-perception of HIV risk. There were no significant differences in sexual risk behaviors, or in HIV incidence between acceptors (1.6/100 PY) and non-acceptors (1.4/100 PY) of VCT. CONCLUSION: In this rural cohort where VCT services are free and accessible, there is self-selection of individuals accepting VCT, and no impact of VCT on subsequent risk behaviors or HIV incidence.

Adolescent↗
PubMed2006

Low rates of acceptance of BRCA1 and BRCA2 test results among African American women at increased risk for hereditary breast-ovarian cancer.

PURPOSE: This study evaluated rates of BRCA1 and BRCA2 (BRCA1/2) test result acceptance among African American women and identified determinants of test result acceptance. METHODS: Acceptance of BRCA1/2 test results was evaluated among 157 African American women at high and moderate risk for having a BRCA1/2 mutation who were offered genetic testing as part of a clinical genetic counseling research program. RESULTS: Twenty-two percent of women received BRCA1/2 test results. Test result acceptance differed between women with > or =10% prior probability of having a BRCA1/2 mutation (34%) and those who had a 5% prior probability (8%). Among women with > or =10% prior probability, test result acceptors were most likely to be married (OR = 5.29, 95% CI = 1.82, 15.38, P = 0.002) and be less certain about their risk of developing cancer (OR = 3.18, 95% CI = 1.04, 9.80, P = 0.04). CONCLUSION: These results demonstrate that acceptance of BRCA1/2 test results may be limited among African American women. Being married and having less certainty about one's cancer risk may motivate acceptance of BRCA1/2 test results among African American women. It may be important to emphasize the possibility that BRCA1/2 test results may not clarify cancer risks during pre-test counseling with African American women to ensure informed decision-making about testing.

Adult↗
PubMed1996

Patients' willingness to accept life-sustaining treatment when the expected outcome is a diminished mental health state: an exploratory study.

OBJECTIVE: To assess patients' willingness to accept life-sustaining treatment when the expected outcome is a diminished mental health state. DESIGN: Structured interviews with a consecutive series of patients. SETTING: A university-based Department of Veterans Affairs Medical Center. PATIENTS: One hundred four male patients (mean age = 65.4 years; range 37-82) seen consecutively in a general medicine clinic. MEASUREMENTS: We assessed the acceptability of temporary ventilatory support of a hypothetical case of severe pneumonia. Patients were asked to consider mental health states involving minor cognitive deficits that varied only in their expected frequency and duration. RESULTS: All patients except one were willing to accept temporary life support in the management of severe pneumonia. Of these 103 patients, 76 patients specified the number of days they would allow themselves to be continued on intubation and ventilatory support. The length of time varied from 1 day to 2 years and was longer when patients reported having had a stroke of reported being in fair of poor health. Fifty patients were willing to accept all diminished mental health states, including the most severe state (F). Patients who reported having been in a medical intensive care unit were more likely to accept intubation in the most severe state (F). CONCLUSIONS: In the case of "severe pneumonia", about half of our older male veterans reported a willingness to accept intubation and ventilatory support even if it resulted in persistent cognitive disability. These results suggest that experience in a medical intensive care unit with the ventilators and experience with strokes may make patients more tolerant of treatments that may result in impaired cognitive function.

Adult↗
PubMed1993

Comparison of medical abortion with surgical vacuum aspiration: women's preferences and acceptability of treatment.

OBJECTIVES: To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN: Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING: Teaching hospital in Scotland. PATIENTS: 363 women undergoing legal induced abortion at less than nine weeks' gestation. MAIN OUTCOME MEASURES: Women's preferences for method of abortion before abortion; acceptability judged two weeks after abortion by recording the method women would opt to undergo in future and by semantic differential rating technique. RESULTS: 73 (20%) women preferred to undergo medical abortion, and 95 (26%) vacuum aspiration; 195 (54%) were willing to undergo either method, and were allocated at random. Both procedures were highly acceptable to women with preferences. Gestation had a definite effect on acceptability in randomised women; at less than 50 days there were no differences, but between 50 and 63 days vacuum aspiration was significantly more acceptable. CONCLUSIONS: Women who wish to use a particular method should be allowed their choice, regardless of gestation. Women of 50-63 days' gestation without preferences for a particular method are likely to find vacuum aspiration more acceptable. A patient centred, partially randomised trial design may be a useful tool in pragmatic research.

Abortifacient Agents, Nonsteroidal↗
PubMed1995

Sex differences in patient acceptance of cardiac transplant candidacy.

BACKGROUND: The overwhelming majority of cardiac transplant recipients are men. This can be partially explained by the earlier age at which heart failure develops in men. However, an underrepresentation of women also may reflect physician referral or selection biases or differences in patients' access to or acceptance of heart transplantation. METHODS AND RESULTS: We investigated whether sex bias occurred in the transplant candidate selection process at a single cardiac transplant center. We prospectively evaluated 386 individuals < 70 years of age (295 men, 91 women) referred for management of moderate to severe heart failure and/or cardiac transplant evaluation. Age, race, sex, heart failure type, New York Heart Association class, left ventricular ejection fraction, peak exercise oxygen consumption, disease duration, resting hemodynamic measurements, comorbidity index score, health insurance coverage, and estimated household income were recorded. For patients not accepted for transplantation, the reason for rejection was also obtained. Univariable and multivariable (logistic regression) analyses were performed comparing men and women and patients accepted and those not accepted for cardiac transplantation. Female sex was independently associated with rejection for cardiac transplantation (odds ratio, 2.57; P = .01). However, the reason for rejection (odds ratio, 2.57; P = .01). However, the reason for rejection was more likely to be patient self-refusal for women than for men (29% versus 9%), and female sex was independently associated with patient self-refusal (odds ratio, 4.68; P = .003). When patients who refused transplant were reclassified as accepted for transplant, female sex was no longer associated with nonacceptance. However, lower patient income was associated with nonacceptance for transplant. CONCLUSIONS: We found no evidence of sex bias in the selection of cardiac transplant recipients at our center. These findings suggest that the underrepresentation of women among cardiac transplant recipients may result, in part, from a sex difference in treatment preference, with a decreased willingness of women to undergo transplantation. The reasons for the difference in acceptance rates between men and women need to be elucidated.

Female↗
PubMed1992

Acceptability of interventions for childhood depression.

Using a case description methodology, this study examined the effects of behavior problem severity, intervention type, and subject race on mothers' acceptability ratings of five interventions used to treat childhood depression. Results indicated that (a) all psychological (behavioral or cognitive-behavioral) interventions were rated more acceptable than pharmacological treatment; (b) among the psychological interventions, the social skills intervention was the least preferred; (c) acceptability of treatments varied as a function of subject race; and (d) severity of depressive symptoms failed to influence acceptability ratings significantly. Psychometric support was found for a revised measure of acceptability (Abbreviated Acceptability Rating Profile; AARP) developed in the context of the present study. Implications of the findings for consultation are discussed.

Adolescent↗
PubMed2006

A survey of the clinical acceptability of screening for postnatal depression in depressed and non-depressed women.

BACKGROUND: Information on clinical acceptability is needed when making cost-utility decisions about health screening implementation. Despite being in use for two decades, most data on the clinical acceptability of the Edinburgh Postnatal Depression Scale (EPDS) come from qualitative reports, or include relatively small samples of depressed women. This study aimed to measure acceptability in a survey of a relatively large, community sample with a high representation of clinically depressed women. METHODS: Using mail, telephone and face-to-face interview, 920 postnatal women were approached to take part in a survey on the acceptability of the EPDS, including 601 women who had screened positive for depression and 245 who had received DSM-IV diagnoses of depression. Acceptability was measured on a 5-point Likert scale of comfort ranging from "Not Comfortable", through "Comfortable" to "Very Comfortable". RESULTS: The response rate was just over half for postal surveys (52%) and was 100% for telephone and face-to-face surveys (432, 21 and 26 respondents for postal, telephone and face-to-face surveys respectively) making 479 respondents in total. Of these, 81.2% indicated that screening with the EPDS had been in the range of "Comfortable" to "Very Comfortable". The other 18.8 % rated screening below the "Comfortable" point, including a small fraction (4.3%) who rated answering questions on the EPDS as "Not Comfortable" at the extreme end of the scale. Comfort was inversely related to EPDS score, but the absolute size of this effect was small. Almost all respondents (97%) felt that screening was desirable. CONCLUSION: The EPDS had good acceptability in this study for depressed and non-depressed women. Women's views on the desirability of postnatal depression screening appear to be largely independent of personal level of comfort with screening. These results should be useful to policy-makers and are broadly supportive of the Edinburgh Postnatal Depression Scale as a suitable tool for universal perinatal depression screening.

Adult↗
PubMed2000

[Acceptability of xenograft in type 1 diabetic patients and by the general French population].

OBJECTIVE: The possibility of using pig xenografts raises the questions of their acceptability and the reasons for reluctance by patients and society, which have not been clearly investigated in Europe. RESEARCH DESIGN AND METHODS: A survey using a multiple-choice questionnaire was conducted to quantify the acceptability of pig xenografts in type 1 diabetic patients potentially concerned by xenografts (n = 377) as compared to a sample of the French population (n = 697). RESULTS: Willingness to accept a xenograft was significantly greater among diabetic patients than the general population (64% vs 54%, P < 0.001). The notion of using pig xenografts appears to be rather well accepted by the general population, and more information might improve acceptability. The acceptance of xenografts in general and pig tissues in particular was higher in diabetic patients. CONCLUSIONS: Because the general population and type 1 diabetic patients are not aware of the sanitary risks specifically related to a xenograft, the decision to use xenografts cannot be based simply on the expectations of possible recipients. The sanitary risks need to be assessed before further xenografts are performed, particularly in diabetic patients whose risk/benefit ratio is not particularly favourable.

Animals↗
PubMed2001

[Factors influencing contraceptive acceptance or refusal in puerperium].

Throughout a cross-section observational descriptive study, 1,010 postpartum patients were included. Data were collected directly with a survey, and women were divided into two groups: 507 (50.20%) women who accept postpartum contraceptive use and 503 (49.80%) women, which did not accept postpartum contraceptive use. Variables with statistical significance related with postpartum contraceptive acceptance or refusal were: patient age (P < 0.05), marital status (P < 0.001), pregnancies number (P < 0.001), parity (P < 0.01), cesarean section number (P < 0.001) and previous contraceptive use (P < 0.001). Postpartum contraceptives more accepted were: intrauterine device (67.85%), and tubal section (28.20%). Main reasons for postpartum contraceptive acceptance were: desire of no more children (27.02%), satisfaction with previous contraceptive methods (21.4%) and gynecologist counseling during prenatal care and delivery room (18.55%). Main reasons for postpartum contraceptive refusals were: husband's rejection of postpartum contraceptive use (33.6%), and delay in postpartum contraceptive use after finishing postpartum (32.0%). It was concluded that according to presence of significant differences between both groups in some variables, these variables should be kept in mind by physicians in promoting contraceptive methods in a personalized manner during prenatal care. Likewise, owing to husband's rejection of postpartum contraceptive use is needed to incorporate the husbands systematically to the prenatal care and to try convincing them of accepting postpartum contraceptive use.

Adolescent↗
PubMedDate not supplied

[Acceptance and rejection of vasectomy in rural males].

BACKGROUND: One problem in rural population is the gap between coverage of contraception and scant masculine participation, which could be due to lack of information of to other sociocultural factors. METHODS: We investigated, in two stages, the characteristics or the profile of the sexual and reproductive behavior of males in an exploratory study by means of focus groups to determine their relevant motivations and characteristics and subsequently, a structured questionnaire to ascertain the magnitude of the factors explored. The population corresponded to zones of rural hospital medical services zones of medical services in seven ethnic groups of the Mexican Republic and included men who accepted and who rejected vasectomy. RESULTS: The profile of males who accepted vasectomy allowed to determine that there exist a unsatisfied demand for contraceptive protection and the desire of not having additional children; in addition, we found that the decision to accept vasectomy is determined to a greater extent for reasons different from that of information on the contraceptive method. The important proportion of males who were non-users of contraceptive methods who accepted vasectomy supposed information on contraception to be the most consistent reason; nonetheless, this information was not considered sufficient and timely; thus, adverse economic situation, a certain condition related with the couple such as health or love for the female partner are the more weighty reasons for deciding to accept vasectomy, while the fear of poor sexual performance is the most powerful factor for rejection of vasectomy. CONCLUSIONS: Masculine participation in family planning is a factor that conditions contraceptive coverage and its respective benefits. The profile of the male who accepts vasectomy aids in identifying candidates forthe procedure and in reducing unsatisfied demand. Greater diffusion of information of the contraceptive method of vasectomy, greater links between male needs and vasectomy, and maintaining or increasing access to family planning are required.

Adolescent↗
PubMed1991

Social acceptability of methylphenidate and behavior modification for treating attention deficit hyperactivity disorder.

The social acceptability of methylphenidate, behavior modification, and methylphenidate plus behavior modification was evaluated. Fifty mothers of children with attention deficit hyperactivity disorder (ADHD) and 50 control mothers, along with 21 children with ADHD and 20 control children, read a case vignette of an 8-year-old boy with ADHD and descriptions of the three treatment conditions. Subjects then rated the acceptability of each treatment. The mothers of children with ADHD were reassessed 3.5 months later, after experience with interventions for their children. Both ADHD and control families rated behavior modification as the most acceptable, methylphenidate as least acceptable, and the combined condition intermediate between the other two. At follow-up, there was a significant improvement in the acceptability of methylphenidate and the combined condition. The increased acceptability of methylphenidate at follow-up was related to increases in parents' knowledge about ADHD but not to the significant improvements that occurred in the children's hyperactive behavior.

Adult↗
PubMedDate not supplied

Group effect on parental rating of acceptability of behavioral management techniques used in pediatric dentistry.

The rating of acceptability by parents either in groups of five or alone of behavior management techniques (BMT) displayed in videotaped vignettes was studied. Ratings of acceptability of the techniques for use on "a" vs. "their" child also were evaluated. Sixty parents were divided randomly into two groups (A and B). For Group A, six groups of five parents viewed a videotape containing eight BMT. All parents in Group B viewed the same videotape individually. Following the presentation of each BMT, the parents were requested to rate the technique for acceptability using a visual analogue scale (VAS). One half of Groups A and B were told to rate the acceptability of each BMT for use on "a" child. The remaining parents in Groups A and B were told to rate the acceptability for "their" child. The results indicated that there were no significant differences between groups (groupings of five vs. alone) or "their" and "a" child ratings. However, there was a consistent trend for those in groups to rate BMT as less acceptable than those rating alone. The implications of these findings are discussed in reference to findings of previous studies.

Analysis of Variance↗
PubMed1991

Determinants of acceptance of routine voluntary human immunodeficiency virus testing in an inner-city prenatal population.

Routine voluntary prenatal human immunodeficiency virus (HIV) counseling and testing offer the opportunity to encourage reduction of high-risk behaviors among uninfected women and to identify those women with asymptomatic HIV infection. To characterize the determinants of acceptance of routinely offered and encouraged HIV testing in inner-city parturients in Atlanta, we identified two groups of women, one that declined HIV testing and another that accepted testing. Each group was asked to complete a questionnaire designed to assess the effectiveness of pre-test counseling. During the 7-month study period, 4731 women registered for prenatal care and 4574 (97%) consented to HIV testing. Nearly all women stated that they were not pressured into having HIV testing performed. Women who accepted HIV testing were more likely to be young, black, and single (P less than .001) and less likely to have received education beyond high school (P less than .05). More accepters than decliners thought the HIV counseling session was valuable (97 versus 91%; P = .04); 55% of accepters agreed to antibody testing because of concern about the risk of transmitting HIV infection to their fetus or infant. More accepters than decliners indicated a willingness to have HIV testing in a future pregnancy (74 versus 33%; P less than .001). These data suggest that most inner-city parturients in our institution view routine voluntary HIV counseling as a valuable component of their prenatal care.

Adolescent↗
PubMed1984

Acceptability and compliance in screening for colorectal cancer with fecal occult blood test.

To evaluate acceptability of and compliance with the Hemoccult-II guaiac test in screening for occult fecal blood, a representative sample of 685 persons 40-74 years old received slides and invitation without previous notice. Sixty-seven per cent accepted. Eight persons (1.7%) had a positive test. Two had rectal cancer, and two had adenomas. Acceptability decreased significantly with age in women but not in men. Eighty-seven per cent agreed to repeated screenings with intervals of 1-2 years. The acceptability was favorable compared with other studies and suggests 70-74 years as the upper limit for screening. Acceptability may even be increased by further information to the population. Written reminders were effective, but telephone calls were not. Compliance was high, since only 20 persons needed further instructions, and the proportion of false-positive tests suggested that dietary instructions had been followed. The high acceptability favors the planning of a major randomized trial of the possible effect of screening on mortality from colorectal cancer.

Adenoma↗
PubMedDate not supplied

Role of amniotic fluid in newborn acceptance and bonding in canines.

Maternal behavior, such as licking and cleaning of the newborn, and oral consumption of the placenta and membranes is characteristic of nearly all mammals. They are the first step toward maternal acceptance and bonding in canines. Factors affecting these initial behaviors are unclear. Also the impact of these initial behaviors in regard to establishing long-term newborn acceptance and bonding is unclear. We undertook this study to determine the role of the amniotic fluid on newborns and oral consumption of the placenta and membranes on the initial development of the maternal-newborn relationship. Thirty litters were studied, nine serving as controls in which the maternal and neonatal behaviors were simply observed for 36 h after delivery. Twenty-one litters underwent three different manipulations and served as the study groups. The first study group consisted of nine litters where the pups, placenta, and membranes were immediately separated from the mother at birth. Pups were washed three times and returned to the mother, and observation began. The second group of nine litters had the pups, placentas, and membranes immediately removed from the mother at birth. These pups were washed three times and returned to their mother. After 2.5 h of observations, pups were bathed in their amniotic fluid and the placenta and membranes returned to mother. In the third study group, three litters had the pups immediately separated from their mother, washed only once, and returned to their mother. The placenta and membranes were removed permanently in this case. In the control group, acceptance of pups was universal. In the first study group, all pups were rejected for the entire 36 h of observation. In the second study group, all pups were rejected until they were bathed in amniotic fluid and the placentas returned to the mother. At this point, the mother accepted all pups. In the third study group, all pups were accepted by the mother during the entire observation period. It appears that having the amniotic fluid on pups is an important signal for the mother to begin licking, accepting, and establishing maternal bonding with the newborn in canines. In the absence of amniotic fluid on the pups, rejection for the first 36 h was universally present.

Amniotic Fluid↗