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PubMed2006

Normative and self-perceived orthodontic treatment need of a Peruvian university population.

BACKGROUND: Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. METHODS: 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. RESULTS: An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4-5 was 29.9% whereas the percentage of students with AC grades 8-10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. CONCLUSION: Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need.

Adolescent↗
PubMed2002

[Structural analysis of users' needs from a community pharmacy related to home care in a suburban area].

OBJECTIVES: To clarify the needs of home care service users needs from a community pharmacy and the functions related to home care in a suburban area. METHODS: A questionnaire on pharmacy services and functions was submitted to 472 home care service users in a suburban area. Gender, age, family status, presence of carers, health condition, home care services being used, prescription and pharmacy utilization status, presence of family pharmacy, and recognition of the need for drug management guidance by home visiting pharmacists were surveyed as well as the users' needs from a community pharmacy and its functions. Using these results, principal component analysis was performed. RESULTS: It was found that the users had a great need for the following services and functions: adequate medication instruction, listening attentively to users, and a good attitude from pharmacists and clerks. Meanwhile, the users' need for home care related services was relatively low, i.e. counseling about home care and welfare services, provision of a home visiting service, and provision of home care supplies. Also, principal component analysis indicated that users' needs consisted of five components, viz, medical services, material supply, convenience, readiness of service provision, and consideration of privacy. Regarding home care related services, counseling about home care and welfare services was related to the medical services; provision of home care supplies was related to the material supply; provision of a home visiting service was related to convenience. CONCLUSIONS: It was shown that users did not clearly recognize a service need for home care services as a new function of community pharmacies. Rather, users recognized the need for home care services connected to these already provided by community pharmacies. Therefore, information provision and education are necessary so that users can clearly understand the details and merits of the home care services which community pharmacies provide.

Aged↗
PubMed2005

Developmental and behavioral needs and service use for young children in child welfare.

OBJECTIVE: To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States. METHODS: As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use. RESULTS: Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in out-of-home care but are less likely to use services. Children <3 years of age are least likely to use services. CONCLUSIONS: Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention.

Adaptation, Psychological↗
PubMed2007

Low-income uninsured children with special health care needs: why aren't they enrolled in public health insurance programs?

OBJECTIVE: We examined potential barriers to enrollment in public programs among low-income children with special health care needs who are uninsured. Barriers considered include parents not knowing about the Medicaid and State Children's Health Insurance programs, not believing that their child is eligible for public coverage, not perceiving the enrollment processes as easy, and not wanting to enroll their child in a public program. METHODOLOGY: The source of data is the 2001 National Survey of Children With Special Health Care Needs. A series of 5 questions about the child's health needs, known as the Children With Special Health Care Needs Screener, was used to identify children with special health care needs. Uninsurance is defined as having no insurance coverage at the time of the survey. Low-income families are defined as those with household incomes below 200% of the federal poverty level. The analytic sample consists of 968 low-income uninsured children with special health care needs. We examined the socioeconomic and demographic characteristics of the sample, the reasons the children lack coverage, and the awareness and perception measures, both individually and combined as a summary measure. RESULTS: Many low-income parents with uninsured children with special health care needs do not have full information about Medicaid and State Children's Health Insurance programs or do not have positive perceptions of the application processes. Although 93.5% had heard of at least 1 of the 2 programs, only 54.6% believed that their child was eligible for public coverage, and just 48.1% believed that the application processes were easy. Almost all said that they would enroll their child if told he or she was eligible for public coverage. CONCLUSIONS: Understanding why uninsured children with special health care needs do not participate in public programs is important, because these programs have the potential to cover almost all of this population. Initiatives to increase enrollment should yield real dividends given that the vast majority of low-income uninsured children with special health care needs have parents who say they would enroll their children in public coverage.

Child↗
PubMed2005

[Health needs according to civil society and the state].

This study focused on the health needs of a population covered by a primary healthcare center (PHC) in the city of São Paulo, Brazil. The overall objective was to investigate the perceived health needs as the object of health work. The study thus identified and analyzed what residents recognize as health needs, as well as what the PHC workers grasp as the object. The PHC workers and local residents were the research subjects. A semi-structured interview was used for data collection and thematic analysis for grasping the reality. The empirical categories identified were: need for state presence, social reproduction needs, and need for political participation recognized by local residents as health needs. The analysis indicated that the PHC work has operated without recognizing the residents' needs. Overcoming such gaps may be possible if and to the extent that work processes are implemented according to the recognition of health needs, respecting the concept of determination in the health-disease process and the right to health as a political gain.

Brazil↗
PubMed2000

Parental employment and health insurance coverage among school-aged children with special health care needs.

OBJECTIVES: This study examined parental employment and health insurance coverage among children with and without special health care needs. Special needs were defined as conditions likely to require a high amount of parental care, potentially affecting parental employment. METHODS: Data from the 1994 National Health Interview Survey were analyzed for 21,415 children aged 5 to 17 years, including 1604 children with special needs. Logistic regression was used to estimate the effect of special needs on the odds of full-time parental employment and on the odds of a child's being uninsured, having Medicaid, or having employer-sponsored insurance. RESULTS: Parents of children with special needs had less full-time employment. Their children had lower odds of having employer-sponsored insurance (adjusted odds ratio [OR] = 0.7) than other children. Children with special needs had greater odds of Medicaid coverage (adjusted OR = 2.3-5.1, depending on family income). Children with and without special needs were equally likely to be uninsured. CONCLUSIONS: Lower full-time employment among parents of children with special needs contributes to the children's being less likely to have employer-sponsored health insurance. Medicaid covers many children with special needs, but many others remain uninsured.

Adolescent↗
PubMed2002

Relationship between children's dental needs and dental care utilization: United States, 1988-1994.

OBJECTIVES: This study describes the relationship between dental needs and dental care utilization among children. METHODS: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to analyze dental care needs and dental care utilization. RESULTS: Younger children with perceived needs (needs perceived by the child or responsible adult) were more likely to be episodic users of dental care than children without perceived needs. Younger children with normative needs (defined by the presence of untreated caries diagnosed by a dentist) were less likely to be regular users. Older children with perceived or normative needs were more likely to be episodic users and less likely to have had a previous-year visit than children with no needs. CONCLUSIONS: Despite their presence, dental needs do not drive dental care use among children, and children's dental care utilization is inadequate.

Adolescent↗
PubMed1999

Urological needs assessment for primary care practice: implications for undergraduate medical education.

PURPOSE: The majority of graduating medical students will become primary care physicians. We discuss what urological topics primary care physicians need to know, proficiency in urological skills of primary care physicians and undergraduate urological curriculum recommendations that would serve the needs of primary care physicians. MATERIALS AND METHODS: A written survey instrument was mailed to all 452 family practice residency directors in the United States. Subjects rated how well family practice physicians need to know urological topics and how proficient they must be in urological skills. RESULTS: A total of 329 responses were received (response rate 73%). Respondents indicated that they need to know urinary tract infection, sexually transmitted disease, epididymitis, benign prostatic hyperplasia diagnosis, hematuria and erectile dysfunction diagnosis very well. They indicated a greater need to know diagnostics than staging or management of prostate, bladder, renal or testis cancer (p <0.05). Among diagnostics respondents indicated that generalists should be highly proficient in urinalysis interpretation. Proficiency was ranked greater for interpretations of semen analysis than excretory urogram, abdominal computerized tomography or magnetic resonance imaging, or renal ultrasound (p <0.05). Proficiency in catheter insertion and circumcision was ranked highly, and vasectomy was ranked moderately. CONCLUSIONS: Primary care physicians need to know and be proficient in many urological topics and skills. They need to know diagnostics better than staging and management information, and urological infectious topics better than urological cancers. They need to be proficient in physical examination, urinalysis interpretation, catheter insertion, circumcision and vasectomy. Undergraduate medical education should reflect these needs.

Clinical Competence↗
PubMed1999

The orthodontic treatment need and demand of Hong Kong Chinese children.

OBJECTIVE: To investigate the need and demand for orthodontic treatment of Chinese school children in Hong Kong. METHODS: The material consisted of study casts and questionnaires collected from 765 randomly selected 12-year-old school children in Hong Kong. The need for orthodontic treatment was assessed by the Index of Orthodontic Treatment Need, and questionnaires were used in assessing demand for orthodontic treatment. RESULTS: The results indicate that 12% of the 12-year-old school children had no need of orthodontic treatment, 18% had little need (Grade 2), 33% moderate need (Grade 3), 33% great need (Grade 4), and 4% of children had very great need for orthodontic treatment (Grade 5). About two thirds of the children were not satisfied with their dental appearance, but only 40% of these would like to have orthodontic treatment. A definite relationship was found between negative self-appraisal of dental appearance and demand for orthodontic treatment. CONCLUSION: The study demonstrates that the need of orthodontic treatment among Chinese children is similar to that of Caucasian children; the attitude and demand toward treatment are also similar.

Chi-Square Distribution↗
PubMed2002

[Disorders requiring nursing care and the period before recognized as needing nursing care (active life expectancy) in relation to nursing care insurance].

PURPOSE: To measure the state of health of the elderly population, active and dependent life expectancies were calculated based on the number of people needing nursing care. For this purpose, active life expectancy was defined as the period before nursing care was recognized by insurers as being required. Moreover, to cast light on disorders requiring nursing care, age-adjusted nursing time needed for different ailments per ten thousand elderly population was calculated. SUBJECTS AND METHODS: Subjects were those 65 years or over living in Taihaku-ku, Sendai City, recognized as needing nursing care by nursing care insurers. The period before being recognized as needing nursing care was calculated using the Sullivan method, and termed the active life expectancy. Dependent life expectancy = life expectancy - active life expectancy. The number of those needing nursing care caused by each disorder diagnosed by attending physicians, was also age-adjusted by the reference population and multiplied by the nursing time needed for each level of nursing, resulting in the age-adjusted nursing time needed per ten thousand elderly population. RESULTS: Those recognized as needing nursing care were 7.5% (7.7% after age adjustment) of the male elderly population, and 12.5% of the female population (10.7% after age adjustment). For men, the active life expectancy was 16.1 years for the age of 65, 9.2 years for 75 and 4.4 years for 85, while the dependent one was 2.0-2.1 years for all ages. For women, the active life expectancy was 19.3 years for the age of 65, 11.1 years for 75 and 4.8 years for 85, while the dependent one was 4.6-5.3 years. The age-adjusted nursing time needed per ten thousand elderly population was 874 hours for men and 1,125 hours for women: of the time 51% was for men with cerebrovascular disease (40% for cerebral infarction), 11% for men with dementia; 37% for women with cerebrovascular disease (26% for cerebral infarction), 20% for women with skeletal diseases, 18% for women with dementia. CONCLUSIONS: The active life expectancy for women is longer than for men, by 3.7 years for the age of 65, by 2.3 years for 75 and by 0.5 years for 85. The dependent life expectancy for women is also longer than for men, by 3.2 years for the ages of 65 and 75 and by 2.6 years for 85. Thus, nursing prevention is an urgent issue, especially for women. The disorders requiring particularly long age-adjusted nursing time are carebrovascular disease (particularly cerebral infarction), dementia and skeletal disorders (particularly among women).

Age Factors↗
PubMedDate not supplied

The effect of dental insurance on the ranking of dental treatment needs in older residents of Durham Region's homes for the aged.

The effect of dental insurance on the ranking of dental needs in older adults has not been reported previously. We examined this effect using data obtained from a cross-sectional survey of older adults living in homes for the aged in Durham Region, Ontario. History of dental insurance was obtained during interviews. Dental needs, assessed during clinical examinations, were ranked from no need to urgent need according to the guideline of the American Dental Association. The associations between the rank of dental needs, dental insurance and other factors were analyzed with the Kruskal Wallis test, chi-square test, analysis of variance and multiple logistic regression. Of the 252 participants, 80 (31.7%) had been insured continuously since 1974, 69 (27.4%) had no need for dental treatment and 59 (23.4%) needed urgent dental care. More of the continuously insured than the uninsured residents were dentate (46/80 [57.5%] vs. 75/172 [43.6%], p = 0.04). Ranking of the need for care was not significantly influenced by dental insurance; need of any kind was explained by being dentate (odds ratio 12.3, 95% confidence interval 5.6 27.3).

Aged↗
PubMed2002

[Differences in subject needs between nursing home residents' and residential care professional's perspectives].

OBJECTIVE: Considerable attention has been directed toward the quality of nursing home care, with a more recent focus on residents' perspectives concerning bio-psychosocial needs. Several researchers have reported professional and patients' perspectives to be consistently different regarding biopsychosocial needs. The objective of this study was to examine such differences. METHODS: A cross-sectional survey was conducted, with interviews of nursing home residents and a self-administered questionnaire for residential care professions. The data were obtained from 85 matched pairs in 6 nursing homes. The measures for subjective needs of the residents had three dimensions (physical, psychological, and social) covering 8 sub-categories. Analyses of the data offered good evidence of reliability (internal consistency) and content validity. RESULTS: In an agreement statistic analysis using Cohen's kappa, the residents' and care professional perspectives significantly differed regarding subject needs. In another analysis using t-tests, measures for subject needs derived from residential care professionals were consistently greater than those with nursing home residents. This tendency was generally consistent across sub-categories by ADL levels. However, the ranking order for the 7 sub-categories for subject needs was very similar with both raters. CONCLUSION: Assessing nursing home residents' subject needs represents an important and essential component of quality of care. However, needs assessment by the residential care profession is still its infancy and includes failure to consider the residents' perspective. The future research challenge is to find reasons for the gap in subjective thinking between the groups. In addition, researchers can perform a critical function on behalf of nursing home residents when they suggest improvements to the methodology for assessing residential care professionals views on residents' needs.

Aged↗
PubMedDate not supplied

Perceived needs of parents of critically ill infants in a neonatal intensive care unit (NICU).

PURPOSE: To identify the perceived needs of parents of infants in a neonatal intensive care unit (NICU). METHOD: A convenience sample of 52 parents of NICU infants completed the NICU Family Needs Inventory that was modified from the Critical Care Family Needs Inventory (CCFNI). Data were analyzed using descriptive statistics. The differences between mother and father responses were analyzed by ANOVA. FINDINGS: The ten most important and least important need statements were identified. The participants reported assurance and information-related needs as the most important, while support needs were ranked as least important. An ANOVA revealed a significant difference between mother and father responses. Fathers ranked support, information, and assurance needs as significantly less important than mothers did. CONCLUSIONS: The findings suggest the need to inform parents of the infants treatment plan and procedures, answer parents' questions honestly, actively listen to parents' fears and expectations, assist parents in understanding infant responses to hospitalization, and other effective nursing interventions to help meet the needs of parents of NICU infants.

Adaptation, Psychological↗
PubMedDate not supplied

Dental care needs and demands in patients attending the dental hospital of the Obafemi Awolowo University Teaching Hospital's Complex Ile-Ife, Nigeria.

BACKGROUND: To compare the pattern of need and demand for dental care in settings where services are paid for through government sponsored insurance programs and out of pocket by individuals. METHODS: Study consisted of first visit patients attending the Dental Hospital. The assessment of normative treatment needs was done. The tooth based treatment needs were assessed by the WHO basic methods and the periodontal needs were assessed by the periodontal need systems PTNS. RESULTS: More males had sought treatment than females. In both sexes, most of the patients demanding treatment belonged to the 17-34 year age group. There was no statistically significant difference between age groups (P = 0.65). 55.4, 8.1 and 1.4 percents sought care for toothache, caries without concomitant pain and dental check-up respectively. Oral surgical care was considered necessary for the main complaint in 50.1% of cases. However, the age group 17-34 year old needed more restorative care than periodontal and the > 65 age group requested more extractions. CONCLUSION: The expressed need or demand for dental care falls short of the normative need. It should therefore be the aspiration of appropriate government ministry and health care providers to attempt converting normative needs into demand for care.

Adult↗
PubMed1987

Family life education needs of mentally disabled adolescents.

This study identifies the family life education needs of minimally and mildly mentally disabled adolescents as a basis for curriculum development. Respondents were 134 students from 11 school districts in a midwestern state. Through the administration of 50 needs statements, they were asked to indicate the magnitude of need and the extent to which the need was being met. Special education teachers were allowed to assist in reading or interpreting the directions and needs statements. Priority need statements--those with a high need score which were not being met--are related to the decision to parent, careers and work, marriage and parenthood, decision making and goal setting, and resource management. Six clusters or groups of family life education needs were identified: Basic Nutrition, Teenage Pregnancy, Sex Education, Developmental Tasks of Adolescents, Marriage and Parenthood, and Planning and Decision Making. Females reported significantly greater need for information on nutrition, teenage pregnancy, and marriage and parenthood.

Adolescent↗
PubMed1984

Need and decision making in dentistry--an economic perspective.

The issue of alternative definitions of need has recently received attention in the dental literature. However, a number of important questions have gone unanswered. Why is it necessary to assess needs; who is to do the assessing and in what decision making contexts are needs to be assessed? This paper presents an economic rationale for assessing needs. Scarcity necessitates choices as to how resources will be used, and it is only by identifying needs and the costs of meeting them that such choices can be made rationally and explicitly. Three levels of decision making are distinguished, together with three assessors of need: patients, dentists and society. It is argued that decisions to seek care and to comply with professional instructions will ultimately rest with patients, whereas decisions as to which individual patients should be given treatment of what type will inevitably lie with the dental profession. In the latter case it is particularly important that dentists' judgements should reflect the social context of their decision making. At a wider community level, it is suggested that dental care professionals have a major role to play in assessing the potential for improvements in the oral health of the population, while the task of making societal decisions as to which needs ought to be met is essentially that of policy makers. Once the legitimate roles of various parties in assessing needs in different decision settings have been established, the concept of need has a key contribution to make to the planning and provision of dental care services.

Decision Making↗
PubMed1996

Family needs of chronic hemodialysis patients: a comparison of perceptions of nurses and families.

OBJECTIVE: The objectives of this study were to (a) determine the psychosocial needs of families of ESRD patients receiving hemodialysis as perceived by nurses and family members; and (b) compare the differences of perception of needs between these two groups. DESIGN: The Norris and Grove Questionnaire (1986) was modified for the hemodialysis population to a 33 statement inventory of psychosocial needs. SAMPLE/SETTING: The sample consisted of 10 family members and nine registered nurses. The setting was a Midwestern Veterans Administration Medical Center hemodialysis unit. METHODS: A telephone survey interview was used for 9 family members; one survey was returned by mail. The RNs returned completed questionnaires to the unit. RESULTS: The findings of this study revealed 6 need statements that were statistically significantly different (p < 0.05) between the two groups. All of these need statements were perceived to be more important by the family members than the nurses. CONCLUSIONS: In this study, family members and nurses differed in what they perceived as important family needs. Families identified at least two psychosocial needs--the need for information and the need for comfort as being very important.

Adult↗
PubMed1996

Needs of family caregivers of patients receiving home hospice care for cancer.

PURPOSE/OBJECTIVES: To identify needs of family caregivers of home hospice patients with cancer. DESIGN: Exploratory, descriptive. SETTING: Six nonprofit homecare hospices in Canada. SAMPLE: Twenty Caucasian family caregivers of 20 patients with cancer enrolled in home hospice. METHODS: Subjects were recruited on admission to hospice and completed the Home Caregiver Need Survey in the home. MAIN RESEARCH VARIABLES: Family caregivers' assessment of their poorly satisfied informational, household, patient care, personal, spiritual, and psychological needs. FINDINGS: Family caregivers needed time for themselves away from the house and for their personal needs. They also lacked sufficient time to rest and did not experience adequate sleep. Caregivers needed to learn ways to help patients maintain some independence. A 24-hour hotline can be an important resource for caregivers. CONCLUSIONS: Family caregivers need social, volunteer, and professional support while caring for a family member at home so that their own physical and emotional health does not suffer. IMPLICATIONS FOR NURSING PRACTICE: To provide guidance and support to family caregivers, nurses should assess the needs of caregivers and tailor interventions to meet those needs. Nurses also should facilitate the development of a social, volunteer, and professional support network.

Adaptation, Psychological↗