Medicine prescription practices of homeopathic undergraduate students in West Bengal, India / 中西医结合学报

To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students.

A survey exploring research perception of homeopathic undergraduate students in West Bengal, India

Background: Prioritizing undergraduate research is emphasized to develop critical analytical skills and thinking, independent writing, future clinical practice, enhanced employability, and improved research productivity. Despite far reaching consequences, research perception of homeopathic undergraduate students has barely been investigated to date. Poor participation of homeopathic undergraduates in research is reflected by a single MEDLINE indexed publication with adequate students’ contribution in the last decade. We aimed to assess their knowledge and attitude towards research and to identify barriers towards successful conduct of research. Methods: Institutional cross-sectional survey was carried out during August-September, 2013 in the four Government undergraduate homeopathic schools in West Bengal, India involving 902 participants. A semi-structured questionnaire was developed for the purpose depending on earlier studies on medical undergraduates. 364 completed responses were analyzed in the end. Results: Study sample mostly spanned 18-25 years of age group (94%), belonged to urban families (44.8%), with no gender differences (almost 1:1) and no physicians in family (73.1%). Maximum complete responses were obtained from 3rd year students (61.5%) and students of Calcutta Homeopathic Medical College and Hospital (51.2%). In spite of willingness to participate and keeping a positive attitude towards research, current involvement, training, knowledge and awareness remained quite unsatisfactory. Lack of infrastructure was identified as the chief barrier towards research. Conclusion: Undergraduates had a positive attitude towards homeopathic research, but need a realistic understanding of the research process. Opportunities for research skill development are underdeveloped.

Introdução: Estimular a pesquisa no nível de graduação é considerado um recurso importante para o desenvolvimento da capacidade de análise e pensamento críticos, redação independente, prática clínica futura, melhorar as possibilidades de inserção no mercado de trabalho e a produtividade em pesquisa. Apesar dessas consequências de amplo alcance, a percepção sobre pesquisa de estudantes de graduação em homeopatia tem sido raramente investigada. A escassa participação em pesquisas de estudantes de graduação em homeopatia é evidenciado pelo achado de um único trabalho indexado em MedLine com expressiva participação de estudantes nos últimos 10 anos. O nosso objetivo consistiu em avaliar o conhecimento e atitude em relação à pesquisa e identificar as barreiras que impedem o sucesso na realização de pesquisas. Métodos: Um estudo transversal foi realizado entre agosto e setembro de 2013 nas quatro faculdades públicas de homeopatia na Bengala Ocidental, Índia, com um total de 902 participantes. Um questionário semiestruturado foi desenvolvido especificamente para este estudo baseado nos resultados de estudos anteriores realizados com estudantes de medicina. Um total de 364 questionários completos foi incluído na análise. Resultados: A maioria dos participantes tinha entre 18 e 25 anos de idade (94%), residia em áreas urbanas (44.8%) e não incluía médicos na família (73,1%). A amostra apresentou homogeneidade em relação ao sexo (quase 1:1). O maior número de questionários completos correspondeu a estudantes do 3o ano (61,5%) e da Faculdade e Hospital Homeopático de Calcutá (51,2%) [...] Conclusão: Os estudantes manifestaram atitude positiva em relação à pesquisa em homeopatia, porém precisam adquirir uma compreensão mais realista do processo de pesquisa. As oportunidades para desenvolvimento de competências de pesquisa são muito escassas.

Understanding of biostatistics among the homeopathic fresh graduates and post-graduate trainees in West Bengal, India

Background: A basic understanding of biostatistics is essential, both for designing quality research and evaluating medical literature. We evaluated the understanding of biostatistics and interpretation of research results among homeopathic fresh graduates’ (House Staffs; HSs) and postgraduate trainees’ (PGTs) in West Bengal, India. Methods: A cross-sectional survey of homeopathic HSs and PGTs in the four government homeopathic schools in West Bengal, India, using a pre-tested, valid and reliable biostatistics multiple choice knowledge, confidence and attitude test questionnaire. Results: Internal consistency of the used questionnaires was acceptable (Cronbach’s á = 0.611 – 0.672). Response rate was only 55.6%. Research journal reading habit was seriously lacking. No one had ever taken any research courses or possessed any advanced degrees or diplomas. The overall mean% correct on statistical knowledge was very poor, 1.0% (95% CI 0.1 – 1.9%) vs. 10.0% (95% CI 8.6 – 11.6%) for HSs and PGTs (P < 0.0001). Comparatively, higher knowledge scores were found in respondents from Mahesh Bhattacharyya Homeopathic Medical College and Hospital (P = 0.003). No one could interpret an unadjusted odds ratio, Kaplan-Meier analysis results, and determine strength of evidence for risk factors. Percentages of correct answers for all other knowledge-based questions ranged between only 2.7 – 9.5%. Respondents’ self-assessed confidence in ability to understand biostatistics ranged between 41 – 60%. Positive attitude towards biostatistics was elicited in 16 – 63% respondents. Conclusions: The respondents seriously lacked knowledge in biostatistics needed to interpret research results. Training programs needs to undergo massive and immediate transformation to include more effective biostatistics training in curricula to encourage meaningful research.

A survey on perception of homoeopathic undergraduate students towards learning environment in an Indian scenario

Background and aims – This research was an attempt to understand the views of students of homoeopathic undergraduate schools in West Bengal, India and to identify areas of strength and weakness in the learning environment. Methodology – An institutional, cross-sectional, observational study was carried out involving 430 students in May, 2013 in two Government homoeopathic medical colleges in West Bengal, India. A seven-item close-ended questionnaire with four point Likert scale was used to determine students’ perceptions of the learning environment, intellectual climate and teacher-student relationship in homoeopathic schools. The questionnaire generated seven subscales – flexibility, student to student interaction, emotional climate, supportiveness, meaningful experience, organization, and breadth of interest. Results – 46.5% of students belonged to rural areas and Bengali was the mother tongue of 93.7% students. 39.5% preferred Bengali as the medium of instruction and group study was preferable to 77.9% students. 47.7% students were dissatisfied with the teaching process and 79.8% preferred the use of multimedia over conventional classroom teaching. Flexibility remained low (mean=1.9, SD=0.9); meaningful experience (theoretical teaching) score was high (mean=2.6, SD=0.9). Scores did not vary significantly (P>0.05) across the pre-clinical and clinical students, but few subscales produced significant differences individually among students of different years. Internal consistency scores of the scale remained questionable (Cronbach’s α 0.310-0.446); however, the scale showed acceptable test-retest reliability (Cohen’s κ 0.680-0.838). Conclusions – This study emphasized the areas requiring improvement in homoeopathic school environment based on students’ perspective. Changes in curriculum, faculty and infrastructure should be planned to improve students’ satisfaction.

Introdução e objetivo: Este estudo buscou entender a percepção de estudantes de faculdades homeopáticas em Bengala Ocidental, Índia, e identificar os pontos fortes e fracos do ambiente de aprendizagem. Métodos: Estudo transversal com desenho observacional realizado en maio de 2013 com 430 voluntários em duas faculdades públicas de medicina homeopática em Bengala Ocidental, Índia. Um questionário com 7 itens respondidos em uma escala tipo Likert de 4 pontos foi aplicada para determinar a percepção dos voluntários a respeito de seu ambiente de aprendizagem, clima intelectual e relação aluno-professor. O questionário gerou 7 sub-escalas –flexibilidade, interação entre Estudantes, clima emocional, suporte, experiência significativa, organização e amplitude de interesses. Cerca de 46,5% dos estudantes procedía de áreas rurais, a língua materna de 93,7% era bengalí, 39,5% preferia que se falasse bengalí nas aulas, 77,9% preferia trabalhar em grupo, 47,7% se manifestaram insatisfeitos com o modelo de ensino e 79,8% preferíam as técnicas multimídias comparadas às convencionais. A flexibilidade foi baixa (media= 1,9, desvio padrão DE = 0,9); a pontuação da experiência significativa (ensino teórico) foi elevada (média= 2,6, DE= 0,9). As pontuações não apresentaram diferenças significativas (p>0,05) entre os estudiantes em fase preclínica e clínica, porém, algumas sub-escalas individuais apresentaram diferenças significativas entre os estudantes dos diversos cursos. A consistência interna do questionário é duvidosea (coeficiente α de Cronbach: 0,310-0,446), porém, a confiabilidade do teste-reteste se mostrou aceitável ( de Cohen: 0,680-0,838). Conclusões: Este estudo assinala as áreas que devem ser melhoradas na aprendizagem da homeopatía desde a perspectiva dos estudantes. Mudanças nos programas de estudos, corpo docente e infraestructura são necessárias para melhoras a satisfação dos alunos.

Self-medication tendencies of patients visiting out-patient departments of Government homoeopathic medical colleges and hospitals in West Bengal, India

Self-medication is mostly prevalent in the low- and middle-income population segments of developing countries, thus reflecting the status of health services. Self-medication has frequently been held responsible for inducing drug resistance, higher cost of further treatment, and other complications. The World Health Organization (WHO) promotes self-medication in rural and remote areas to reduce the burden of health services. In this study, the researchers sought to establish the prevalence, consequences, and causes of self-medication. Methods: Multicenter, institution-based, cross-sectional study conducted with 456 participants in May, 2013 at the outpatient clinics of 2 Government homeopathic medical colleges in West Bengal, India. A pilot-tested structured questionnaire consisting of 12 self-administered questions in local vernacular Bengali was used; 8 were close-ended questions providing multiple answer options, while 4 were open-ended. Results: Overall, 12.7% of interviewees admitted to perform self-medication; 57.7% and 66.0% had appropriate knowledge of the medicines and dose regimens, respectively. Females (64.3%) predominated and self-medication was mostly found in age range 31-45 years old (32.5%). Conventional Western medicine (82.2%) was most preferred therapy, and fever (35.7%), hyperacidity (25.4%) and loose stool (24.3%) the most frequently reported complaints. The main causes for self-medication were feeling no need to consult doctor (32.5%), busy schedule (16.4%), family members advice (16.0%), over-the-counter (OTC) availability of medicines without prescription (12.5%), direct consumer pharmaceutical advertisement (12.1%), and high expenditure in private institutes (10.1%). The chi-square distribution of determinants across the two samples differed significantly. The tendency increased proportionately with literacy (Yates’ ÷2=175.731; p=0.000) and poverty (Yates’ ÷2=426.817; p=0.000).

A prevalência da automedicação é mais elevada nos segmentos populacionais de baixa e média renda nos países em desenvolvimento, como reflexo de nível de atenção pública. A automedicação é frequentemente considerada como causa de resistência a medicamentos, aumento do custo do tratamento e outras complicações. Os autores do presente estudo objetivaram investigar a prevalência, consequências e causas da automedicação. Métodos: estudo multicêntrico, institucional e transversal incluindo 456 indivíduos que consultaram em maio de 2013 os ambulatórios de 2 hospitais universitários homeopáticos públicos em Bengala Ocidental, Índia. Foi distribuído para auto-aplicação um questionário estruturado previamente validado num teste piloto. O questionário incluía com 8 perguntas fechadas, com múltiplas opções de resposta, e 4 abertas, na língua vernácula local. Resultados: Aproximadamente 12,7% dos entrevistados admitiram se utilizar de automedicação; 57,7% e 66,0% tinham conhecimento adequado sobre o medicamento utilizado e posologia, respectivamente. A amostra esteve composta predominantemente por mulheres (64,3%), e a faixa etária com maior frequência de automedicação foi a de 31-45 anos (32,5%). A medicina convencional foi indicada como a preferida (82,2%) e as queixas mais frequentes foram febre (35,7%), azia (25,4%) e diarreia (24,3%). As principais causas para a escolha de automedicação foram: sem necessidade de consultar um médico (32,5%), falta de tempo (16,4%), conselho de familiares (16.0%), existência de medicamentos de venda livre (12.5%), publicidade farmacêutica dirigida diretamente ao consumidor (12.1%) e alto custo de serviços de saúde privados (10,1%). O teste de qui quadrado identificou diferença significativa na distribuição dos determinantes entre os dois grupos. A tendência para uso de automedicação aumentou paralelamente ao nível de educação (Yates χ2=175,731; p=0.000) e à pobreza (Yates χ2=426.817; p=0,000).