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PubMed2001

Measles immunization acceptance in Southeast Asia: past patterns and future challenges.

Despite substantial increases in immunization rates, measles remains a major health problem in developing countries of Southeast Asia. The authors of this paper undertook separate investigations which examined factors influencing measles immunization acceptance in the rural Philippines, Central Java, Indonesia, and an impoverished neighborhood in Bangkok, Thailand. We briefly summarize the findings of our three field investigations before presenting a synthesizing analysis of the psychosocial and demographic factors which affect measles immunization. We then review trends influencing measles acceptance in industrialized countries to anticipate possible future challenges to measles immunization acceptance in Southeast Asia in an era of increasing globalization and information transfer. We suggest that parental perceptions of the risks and benefits of immunization, philosophical and religious convictions and state and social regulatory policies will profoundly influence measles immunization in the new millennium.

Asia, Southeastern↗
PubMed2002

Method of risk assessment affects acceptance rate of amniocentesis.

Risk assessment for aneuploidy is an integral part of modern obstetrics. However, patients might choose or reject an amniocentesis, based, not on the risk, but on the screening method used. We examined records of patients referred for evaluation of aneuploidy risk from January 1999 to December 2000. Patients found to have a risk above 1/250 were offered amniocentesis. Out of 555 patients found at risk, 336 (60.5%) accepted. Acceptance rate varied depending on risk factor identified: advanced maternal age 178/290 (61.4%), abnormal serum screening 107/198 (54%), sonographic markers 35/48 (72.9%) or a previous child aneuploidy 16/19 (84.2%). The risk assessment method used influences significantly the amniocentesis acceptance rate and may affect sensitivity of testing.

Amniocentesis↗
PubMed2002

Patient acceptance of educational voice messages: a review of controlled clinical studies.

OBJECTIVES: The objective of this study was to evaluate controlled evidence on the impact of automated computer-based telephone messaging technology upon health outcomes, cost savings and acceptance by patients, caregivers and care providers. METHODS: Systematic searches of electronic databases were conducted to find controlled clinical studies of automated phone messaging used in patient care. Studies were selected based on the three criteria: 1) randomized controlled trials or controlled trials; 2) patients receiving health care related education, information, advice or reminder for a specific action to be taken in their home setting; and 3) use of automated computer-based phone technology to deliver the messages. Information abstracted from studies included information about the institution, persons targeted, intervention and its effect on health outcomes, costs and acceptance by patients and caregivers. RESULTS: A total of nineteen studies were identified for review. Sixteen studies were randomized controlled trials and three were controlled studies with no randomization. Studies were placed in two categories, preventive care education and chronic care studies. Preventive care education studies covered childhood immunizations, medication compliance, influenza vaccinations, tuberculosis and health prevention activities and chronic care studies were related to cholesterol, diabetes, hypertension and congestive heart failure. More than 80% of studies showed significant impact upon measurable health outcomes. CONCLUSIONS: Controlled evidence substantiates the efficacy of automated telephone communication in improving the quality of care. Educational voice messages are acceptable in patients and represent an important opportunity to enhance telemedicine and telehealth applications.

Automation↗
PubMed2003

Acceptability of antenatal HIV testing in Ireland.

To assess the acceptability of antenatal HIV testing. A questionnaire based study. Obstetric outpatient clinic at the Portiuncula Hospital, Galway, Ireland. Women attending the antenatal clinic between May and November 2000. The participating women received pamphlets explaining HIV testing in pregnancy before completing the questionnaire. The questions included assessment of their views towards prenatal HIV testing, perceived benefits and acceptability. Seven hundred and forty-eight questionnaires were distributed. Of these 715 (96%) completed questionnaires were returned out of which 32 (4.5%) were discarded because they were improperly completed. 683 (96%) correctly completed questionnaires were analysed. 650 (95.2%) women agreed that prenatal HIV testing was a good idea and that test was necessary, 17 (2.5%) said test was not a good idea, 30 (4.4%) said test was unnecessary and 16 (2.3%) and 3 (0.4%) women were unsure whether or not test was a good idea and necessary respectively. Three hundred and sixty two (53%) women were of the opinion that prenatal HIV testing was of benefit to the mother and her baby; 301 (44%) to the mother, baby and the health workers; 14 (2%) to the baby; and 3 (0.4%) only to the mother. Only 3 (0.4%) women reported that prenatal HIV testing was of no benefit. The majority of the women, 436 (63.8%) had second level education, 202 (29.6%) received third level and 45 (6.6%) had only primary education. Antenatal HIV testing is acceptable to the majority of the obstetric population studied.

Adult↗
PubMed2003

Maternal views and acceptance of antenatal HIV screening in a university teaching hospital in Hong Kong.

OBJECTIVE: To assess maternal acceptance, knowledge, attitude, perceived risks and barriers toward antenatal HIV screening. STUDY DESIGN: Prospective anonymous survey of 1,519 pregnant women recruited in a university teaching hospital RESULTS: Women demonstrated fairly good knowledge of and a positive attitude toward HIV screening. Condom usage was 61.4%, and 25.3% of women had at least 1 risk factor for HIV infection. Support for mandatory and universal screening was 31.4% and 48.8%, respectively. A total of 82.6% women agreed to HIV testing. The major reason for declining the test was that women considered themselves to be at low risk (84.3%). Women with risk factors tended to prefer more aggressive methods of antenatal testing (P < .001) and more readily accepted HIV screening (89.8% vs. 73.1%, P < .001). CONCLUSION: Given the high acceptance rate in our local population, universal offering but voluntary testing is the optimal mode of antenatal HIV screening in Hong Kong.

Adult↗
PubMed2004

Acceptance of screening and completion of treatment for latent tuberculosis infection among refugee claimants in Canada.

SETTING: Primary care clinic for refugee claimants, Montreal, Canada. OBJECTIVES: To identify factors linked to the acceptance of the tuberculin skin test (TST), and assess completion of treatment for latent tuberculosis infection (LTBI). DESIGN: Asylum seekers consulting for a medical complaint or medical immigration examination between February and October 1999 were assessed for eligibility. Personal and clinical information was gathered prospectively by questionnaire. Hospital files were reviewed to assess completion of LTBI treatment. RESULTS: In our study, 296 subjects (72.4% of 409 eligible) were offered TST, of whom 227 accepted (76.7%). Of these, 49 (24.9%) had a TST > or = 10 mm and 24 (49%) completed 6 months of LTBI treatment. Logistic regression models showed that patients who had never had a TST (OR 3.2, 95%CI 1.34-7.6) or had no temporary exclusion criteria (OR 4.0, 95%CI 1.6-9.9) were more likely to accept TST. Perceiving tuberculosis as a severe disease (OR 0.29, 95%CI 0.09-0.91) and consulting for an immigration examination (OR 0.42, 95%CI 0.18-0.98) was associated with refusal of TST. Increasing age was found to be independently associated with a positive TST (OR 1.06, 95%CI 1.01-1.12). Variability in the proportion of positive results was found between TST readers. CONCLUSION: This study supports the feasibility of screening refugee claimants for LTBI during medical consultation and of developing organizational links to ensure completion of LTBI treatment.

Adolescent↗
PubMedDate not supplied

Potential factors that may affect acceptance of routine prenatal HIV testing.

BACKGROUND: Despite increasing advocacy for an "opt-out" strategy in routine prenatal HIV screening programs in Canada, no published studies have examined factors that may affect acceptance of prenatal HIV testing. METHODS: We included all pregnant women in Alberta who received prenatal care (N = 38,712) and their caregivers (N = 2,007) between January 1 and November 30, 2000. Factors associated with non-acceptance of HIV testing in both pregnant women and their caregivers were assessed using multivariate logistic regression. RESULTS: Overall, 1.5% of women declined HIV testing. First Nations women were about twice as likely to decline the test (adjusted odds ratio [OR(adj)] 1.91, 95% CI [1.42-2.58]) compared to non-First Nations women (p < 0.001). The proportion also increased with age (chi2 trend p < 0.001) in the general population. In First Nations women, however, most (3.2%) declined in the 20-24 year age group. No significant effect was seen for a socio-economic status marker or for the place of residence. The caregivers of women who declined HIV testing were more likely to be female (OR(adj) 1.56 [1.28-1.89]), midwives (OR(adj) 140.65 [58.61-337.49]), other non-obstetrical medical specialties (OR(adj) 4.92 [1.94-12.47]), and general practitioners (OR(adj) 3.44 [1.87-6.33]). CONCLUSION: In an "opt-out" routine prenatal HIV screening program, the characteristics of both the pregnant women and their caregivers may contribute to the non-acceptance of HIV testing. A higher likelihood of declining HIV testing among First Nations pregnant women and other pregnant women under the care of midwives and female physicians warrants further study.

AIDS Serodiagnosis↗
PubMed2004

Acceptance and completion of hepatitis B vaccination among drug users in New York City.

Hepatitis B (HBV) vaccination rates remain low among drug users. We examined correlates of vaccine acceptance and completion in two ongoing prospective studies of young injecting and non-injecting drug users in New York City. Street recruited drug users were enrolled at one of two neighbourhood locations (Harlem and the Bronx) between 2000 and 2004 and completed risk behaviour questionnaires and HBV testing. Free HBV vaccination was offered. Among 1117 participants, 26.1% (275) had a previous HBV infection, 57.9% (610) were susceptible to HBV, and 16.0% (169) had serological evidence of previous vaccination. Of the 610 participants susceptible to HBV, 466 (76.4%) returned for their results and were offered vaccination; 53.9% (251) received at least one dose of the vaccine (acceptors). Correlates of vaccine acceptance included older age, public assistance as main income source, and being recruited in the Bronx. Daily crack users were significantly less likely to initiate the vaccine series. Among 240 vaccine acceptors, 98 (40.8%) completed all three doses. Daily injectors, Hispanics, and those recruited in Harlem were less likely to complete the vaccination series. HBV vaccination acceptance among drug users seems likely in programmes that are convenient and offer remuneration; however, extended efforts are needed to improve series completion.

Adult↗
PubMed2006

Patient acceptance of medical student participation in an outpatient obstetric/gynecologic clinic.

OBJECTIVE: To determine which patients, based on selected patient, physician and visit information, were more likely to accept medical student participation in an outpatient visit. STUDY DESIGN: A cross-sectional study conducted at a university-based private practice, evaluated 560 patients presenting for routine outpatient obstetric or gynecologic care. Participants completed a consent form regarding medical student participation in their visit. Patient, visit and physician demographic variables were abstracted. Comparison groups were those patients who accepted vs. those who refused medical student involvement. RESULTS: The majority of patients (75.8%) accepted student participation in their care. Patients who were black, were new to the office, were scheduled to see junior faculty and were evaluated for a vaginal discharge were more likely to refuse student participation. Patients seen for urinary incontinence were more likely to agree to medical student participation. CONCLUSION: The majority of patients consented to medical student involvement. Using a brief survey, we identified patients who are more likely to allow medical students to participate in their visit. We will continue to query all patients regarding medical student teaching but will assign medical students accordingly to maximize their learning experience. We will also educate patients on the benefits of including medical students in the outpatient visit.

Adult↗
PubMed2006

Acceptance of pneumococcal vaccine under standing orders by race and ethnicity.

PURPOSE: To assess whether and how pneumococcal vaccine acceptance occurs after nurse recommendation varies by race/ethnicity. METHODS: We prospectively evaluated nurses' standing orders to assess and vaccinate high-risk patients in a general medicine practice. RESULTS: Of 370 adult patients surveyed (60% nonwhite), 78 (21%) declined vaccination following nurse recommendation, and 43 (12%) persisted in declining after physician consultation. Three-hundred-twenty-seven (88%) patients accepted vaccination: 292 (79%) accepted following nurse recommendation and 35 (9%) following physician consultation. African Americans (19%) were significantly more likely to decline compared with whites (8%) and Asians (5%) (P= 0.01). Reasons for refusal included believing vaccination was unnecessary (32%), fearing shots in general (21%), fearing vaccine-induced illness (26%) and wanting more informotion regarding the vaccine (9%). CONCLUSION: Standing orders, physicians' firm recommendations and addressing patients' vaccine-related concerns may reduce racial/ethnic disparities in vaccination.

Adult↗
PubMed2006

[Acceptability of HIV screening in patients suffering from sexually transmitted infections at the antiveneral center of Abidjan, Côte-d'Ivoire].

The systematic screening in high risk groups can be an efficient way to struggle against HIV/AIDS. We have conducted a transversal descriptive study in patients suffering from STI and who had consulted the antiveneral dispensary of the Institut National de Santé Publique (Abidjan) from 1st September 2002 to 31st October 2002. The aim was to identify the acceptability of the HIV screening test. During this inquiry, 167 patients were recruited. This study permits to confirm the young age of the population with a male predominance in patients having sexual transmitted infections. So, 70.1% have accepted to do this test. However, 23.4% of patients recruited had really done the HIV test. Among those who have accepted to do the test, 28.2% were infected.

AIDS Serodiagnosis↗
PubMed1991

[Patterns in the household acceptance of oral rehydration therapy in a cohort of rural mothers].

The household acceptance of oral rehydration solution salts was studied in a cohort of 75 rural mothers over a two year period. The study was carried out in a rural Mexican village between August 1985 and February 1988. There were 636 episodes of diarrhea, with an average of four episodes per child per year. There were no deaths due to diarrhea or its complications and only 2% of these episodes required the use of parenteral solutions. Acceptance of oral rehydration remained around 50% during subsequent bouts of diarrhea. Variables such as a medium high socioeconomic level of the family, and the reading of journals and newspapers by the mother and the presence of water supply in the home were significantly associated with the acceptance of oral rehydration treatment. On the other hand, families classified as traditional rejected the procedure with significantly higher frequency. The data presented indicates the need for redesigning oral rehydration, treatment programs to increase their impact at the community level.

Adult↗
PubMed1990

[Study of social acceptance of periodic examinations by machine industry workers].

Social acceptance of periodical examinations was evaluated via a survey conducted among a group of 530 machine industry workers. A questionnaire for prophylactic examinations was used which was worked out at the Department of Epidemiology and Statistics of the Nofer Institute of Occupational Medicine in Lódź, with additional questions concerning the level of acceptance of a new medical examination mode. In order to determine the letter the subject area was limited to elicit an answer to a question whether a new examination instrument at a periodical check-up meets the needs of the workers. The paper discusses the method of the study, characteristics of the population examined, including age, occupational exposure and work strenuousness. The findings revealed that 96.8% of subjects had accepted the new mode of periodical examinations which allows a conclusion that the method satisfies the workers' expectations as they find it suitable for managing their health problems. It is suggested that the form of periodical examinations should be modified since those presently applied do not facilitate early diagnosis or comprehensive evaluation of workers' health conditions.

Adolescent↗
PubMed1990

[Acceptance of HIV antibody testing among pregnant women].

During the period April 17-July 14, 1989, 820 pregnant women were offered HIV-antibody testing at the antenatal clinic, Aarhus Municipality Hospital. Seven hundred and seventy-nine (95%) agreed to complete a questionnaire concerning, among other things, previous HIV-antibody testing. 20% of the participants had been tested previously, half of them because they were blood donors. More than 3% had been tested because of self-perceived risk behaviour or a risk environment. In three women, the previous test had shown HIV-antibodies to be present, and three further women refused to report the test result. 81% of the women consented to be tested. Acceptance declined during the project period. Those who had not been tested previously consented more frequently than those who had. Students were less willing to consent than others. Nineteen out of 20 women (2.6%), who considered themselves at high risk, accepted the offer to be tested. Thirty-eight (5%) of the 150 women who declined to be tested, would have accepted if their general practitioner had suggested it. None of the women tested at present were found to be HIV-antibody positive. When the project was terminated, a total of 87% of the women had been HIV-antibody tested previously or at present. We suggest routine HIV surveillance of pregnant women by use of voluntary HIV-antibody testing in combination with anonymous testing (AUT technique) in case the women does not want to know the test result.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Psychotherapy motivation and psychotherapy acceptance. Initial results of the Mannheim intervention study].

In our controlled longitudinal study of a representative high-risk sample of psychogenically impaired individuals, within a multidimensional model of mental health, the variables "life event", "social support" and "personality" are examined concerning their analysis of variance and their interdependence. We assume that a therapeutic influence on the variable "personality" causes a modified risk of becoming psychogenically impaired, and intend to prove this in terms of the altered maturity of defenses, the improved ego-functions, but also in terms of the improvement of the social network and the rarer constellation of critical life events. The modified effect on the variable "personality" is a differential offer of psychoanalytic therapy. By means of our instruments of investigation we tried to clarify if the acceptance of psychotherapy offered to resp. the motivational situation of our probands in regard to a psychotherapy covariates with certain sociodemographically or depth psychologically measurable personality patterns. There was a trend towards accepting the offer of therapy in case of high psychical and socio-communicative psychogenic impairment and in case of relatively high frankness on the FPI scale. The acceptance of an offer of therapy correlated highly significantly with the frankness scale of the Bond questionnaire extended for several defense items. The implications of this finding are discussed.

Cohort Studies↗
PubMed1989

[Flurbiprofen in gel: study of acceptability, tolerability and evaluation of its allergenic potential].

The study aimed to assess the allergenic capacity of gel-based flurbiprofen in healthy volunteers, and then evaluate its acceptance and tolerability in patients affected by various skin diseases. Twenty-five healthy volunteers of both sexes (age range: 19-35 years) were included in the first phase of the study. Allergenic capacity was evaluated using Kligman's maximization test in which 5 patch tests were carried out on the same site using a solution of 2.5% lauryl sulphate, followed by patch tests using gel-based flurbiprofen. Control tests were performed 15 days later. The second phase of the study comprised 15 hospitalised patients, with an age range of between 18 and 70 years, affected by psoriasis and eczema. All patients were treated with gel-based 5% flurbiprofen twice daily for 2 weeks. Patients were asked to fill in a questionnaire in order to assess the acceptance and tolerability of the drug. Only one subject in the first group showed an allergic response to the drug. Adverse effects were observed in two patients in the second group. Drug acceptance was excellent.

Adult↗
PubMed1989

Acceptability of alternative treatments for persons with mental retardation: ratings from institutional and community-based staff.

The acceptability of four behavior modification procedures to direct-care and supervisory staff members of community-based (Experiment 1) and institutional (Experiment 2) facilities for persons with mental retardation was evaluated. Using the Treatment Evaluation Inventory (Kazdin, 1980a), staff members rated differential reinforcement of other behavior (DRO), time-out, overcorrection, and contingent shock, each applied to a mild and a severe behavior problem. Results from both experiments showed that treatments were rated according to their restrictiveness; DRO was most acceptable, followed by time-out, overcorrection, and shock. There was also a problem by treatment interaction in each experiment. No differences were found between the ratings of direct-care and supervisory staff members in either study. Results were discussed in relation to previous treatment acceptability research.

Adult↗
PubMed1985

Exploring user acceptance of a robotic arm: an aesthetic orientation.

An industrial robotic arm has been programmed for use by quadriplegics, as a personal assistant in a rehabilitative setting. This case study is an investigation of the acceptance of this device by disabled individuals who may be likely to use the robot in an actual home or work setting. The use and acceptance of assistive devices have been a significant problem in the utilization of these instruments. An assessment of attitudinal changes of selected quadriplegics in response to the presentation of two orientation programs on the use of a robotic arm was the focus of this project. One program included a discussion of aesthetic sequences of robotic movement, industrial design, and kinetic art. In contrast, the other program presented the "standard" introduction to the robotic arm which involves utilitarian sequences of robotic movement. A robotics questionnaire was administered to both groups before and after the treatment operations. A follow-up study has been conducted. One of the subjects participating in the aesthetic treatment was part of this experiment which followed the posttest. The subject in the follow-up study was trained to use the Robotic Aid for utilitarian tasks. The questionnaire was readministered to this individual in a post-posttest. The whole study can be conceived of as series of investigations of the hypothesis that aesthetic movement of a robotic arm can affect an individual's attitude toward the acceptance and use of robots. As a piece of exploratory research, this case study does not reveal conclusive evidence to support the hypothesis.

Arm↗