Oral Health Beliefs, Perceptions and Utilisation of Oral Health Care Services among the Indigenous People (Orang Asli) in Pahang, Malaysia: A Qualitative Study

@#Introduction: Orang Asli refers to the indigenous people of Peninsular Malaysia, representing 0.6% of the Malaysian population. Vast inequality was observed regarding oral health beliefs, behaviour, and utilisation of oral health services between the Orang Asli and non-Orang Asli. The aim of the study was to explore the oral health beliefs, perceptions, and oral health service utilization behaviour among Orang Asli in the district of Bera, Pahang, Malaysia. Methods: Orang Asli’s oral health beliefs and perceptions of oral healthcare service were ascertained through four FGDs. Nineteen participants from Bera’s semi-urban and rural Orang Asli communities were convened. Emerging themes from the qualitative data were analyzed using thematic analysis. Results: Orang Asli believed that oral health is essential for an individual’s function and aesthetics. They are also aware that inadequate oral hygiene care will result in tooth decay and gum disease. Most of the Orang Asli that chewed betel nuts believed that limestone paste could cause oral cancer. The main barriers to Orang Asli accessing oral healthcare services were time constraints and distance to the nearby clinic. Conclusion: The Orang Asli believed oral health care is essential in ensuring a healthy oral condition. Despite their generational belief towards traditional healers and medication, Orang Asli in Bera had a perceived positive acceptance towards oral healthcare services.

Vulnerabilidade ao HIV entre usuários de CAPSad: crenças e comportamentos em saúde / HIV vulnerability among CAPSad users: relationship between beliefs and health behaviors / Vulnerabilidad al VIH entre usuarios de CAPSad: creencias y comportamientos en salud

O abuso de álcool e outras drogas é uma importante questão de saúde mental para a população adulta e adolescente. Entre os eventos associados a esse abuso, encontra-se elevada vulnerabilidade ao HIV. O presente estudo buscou avaliar, em usuários de substâncias, a relação entre: gravidade percebida do HIV, autoeficácia para uso de preservativo e vulnerabilidade ao HIV. Trata-se de um estudo transversal, quanti-qualitativo, com usuários de um Centro de Atenção Psicossocial para Álcool e Outras Drogas (CAPSad) no Brasil. Os resultados indicam não haver associação significativa entre gravidade percebida do HIV e vulnerabilidade ao HIV (ρ de Spearman de -0,109 e valor-p de 0,507). Contudo, foi identifi-cada uma associação negativa marginalmente significativa entre autoeficácia para uso de preservativo e vulnerabilidade ao HIV (ρ de Spearman de -0,302 and valor-p de 0,061). Neste artigo, discutimos o estigma relacionado ao HIV/aids e realizamos uma crítica a intervenções baseadas no medo, recomen-dando contra seu uso. Em contrapartida, são propostas estratégias para o desenvolvimento da autoe-ficácia, de modo a fortalecer a autonomia dos usuários de CAPSad.

The abuse of alcohol and other drugs is an important mental health issue in the adult and adolescent population. Along with other concerns, substance use can be associated with a higher vulnerability to HIV infection. This study aimed to assess the relationship between three variables in substance users: HIV perceived severity, condom use self-efficacy, and HIV vulnerability. This was a cross-sectional, quanti-qualitative study on outpatients from a Psychosocial Care Center for Alcohol and Other Drugs (CAPSad) in Brazil. Our findings indicate no significant association between HIV perceived severity and HIV vulnerability (Spearman's ρ of -0.109 and p-value of 0.507), and a marginally significant negative association between condom use self-efficacy and HIV vulnerability (Spearman's ρ of -0.302 and p-value of 0.061). In this paper, we discuss the stigma related to HIV/aids and criticize fear-based preventive interventions, recommending against them. On the other hand, we propose strategies for self-efficacy development, aiming to strengthen the autonomy of CAPSad users.

El abuso de alcohol y otras drogas es un importante problema de salud mental para la población adulta y adolescente. Entre los eventos de salud a ele asociados, se encuentra elevada vulnerabilidad a infección por VIH. El estudio buscó evaluar la relación entre: gravedad percibida del VIH, autoeficacia para el uso del condón y vulnerabilidad a el VIH. Este es un estudio transversal, cuanti-cualitative, con usuarios de un Centro de Atención Psicosocial para el Alcohol y Otras Drogas (CAPSad) en Brasil. Los hallazgos indican ausencia de asociación entre gravedad percibida del VIH y vulnerabilidad a el VIH (ρ de Spearman de -0,109 y valor-p de 0,507); y una asociación negativa marginalmente significativa entre esta última variable y autoeficacia para el uso de condón (ρ de Spearman de -0,302 y valor-p de 0,061). En este trabajo discutimos el estigma relacionado con el VIH/sida y criticamos las intervenciones basadas en el miedo, recomendando contra su uso. Por otro lado, se proponen estrategias para el desarrollo de la autoeficacia, con el fin de fortalecer la autonomía de los usuarios del CAPSad.

Creencias en salud bucal en personas que asisten a una facultad de odontología. Estudio cualitativo

Objetivo: Explorar las creencias en salud bucal de personas que asisten como pacientes a una facultad de odontología de una universidad privada regional chilena. Metodología: Estudio cualitativo que exploró las creencias acerca de salud bucal de 11 personas que asistían por tratamiento a una universidad privada chilena, a través de entrevistas semi-estructuradas, transcritas verbatim. Se realizó análisis de contenido en Atlas-ti 8.4, construyendo categorías y subcategorías, tanto predeterminadas como emergentes. Se realizó triangulación entre los investigadores. Se contó con la autorización del comité de ética e investigación y se realizó consentimiento informado. Resultados: Se generaron cinco categorías: creencias sobre caries dental, creencias sobre enfermedad periodontal, creencias sobre pérdida dentaria, creencias sobre higiene bucal y origen de las creencias en salud bucal, reflejando creencias en salud variadas, nutridas principalmente de su entorno cercano y no profesional. Conclusión: Las personas que acuden a una facultad de odontología por atención presentan creencias en salud más ajustadas a caries, que a periodontitis y a pérdida dentaria. El origen de las creencias usualmente es la familia y conocidos, más que de profesionales.

Aim: To explore the beliefs in oral health of people who attend a dental school of a private regional Chilean university as patients. Methods: A qualitative study explored the beliefs about oral health of 11 people attending a private Chilean university for treatment, through semi-structured interviews, transcribed verbatim. The content was analyzed in Atlas-ti 8.4, building predetermined and emerging categories and subcategories. Triangulation was carried out among the researchers. The study was authorized by the Ethics and Research Committee and informed consent was obtained. Results: Five categories were generated: beliefs about dental caries, beliefs about periodontal disease, beliefs about tooth loss, beliefs about oral care, and origin of beliefs in oral health. Varied health beliefs were reflected, influenced mainly by their close and non-professional environment. Conclusions: People who attend a dental school for care present health beliefs more related to caries than to periodontitis, oral care, and tooth loss. The origin of the beliefs is usually family and acquaintances, rather than dentists.

COVID-19: a influência de fatores psicossociais na crença acerca da pertinência do isolamento social no Brasil / COVID-19: The influence of psychosocial factors in the belief of relevance of social isolation in Brazil / COVID-19: la influencia de los factores psicosociales en la creencia sobre la relevancia del aislamiento social en Brasil

A pandemia de COVID-19 impele a compreensão de diferentes aspectos que condicionam a formação da percepção social acerca deste fenômeno. Este estudo teve como objetivo identificar variáveis psicossociais que predizem a adesão à crença de que isolamento social previne o contágio de COVID-19. Para isto se realizou um estudo correlacional, no qual responderam a um questionário online 498 participantes com idade média de 34,9 anos. Um questionário sociodemográfico, escalas de atitudes e crenças em saúde compuseram os instrumentos de pesquisa. Análises descritivas, correlações e análise de regressão linear múltipla foram utilizadas. Os resultados demonstraram que atitudes políticas contribuem na formação da crença acerca do isolamento social no contexto da COVID-19. As interrelações demonstraram que identidades políticas desempenham papel importante na adesão aos discursos de instituições sanitárias ou políticas. Evidencia-se que dimensões psicossociais devem ser levadas em consideração no enfrentamento ao contágio da COVID-19.

The pandemic of the COVID-19 can lead to understanding several aspects of the social formation perception about this phenomenon. This study aimed to identify psychosocial variables that predict the adoption of the belief that social isolation prevents the infection of COVID-19. A correlational study was used with 498 people who answered an online questionnaire. The average age was 34.9 years. The research instrument was composed of sociodemographic questionnaire, scales of attitudes and health beliefs mode scale. Descriptive analysis, correlations and multiple linear regression analysis were used. The results revealed that political attitudes contribute to the formation of the belief about social isolation in the context of COVID-19. Interrelations have shown that political identities have an important role in adhering to the policies of health or political institutions. It has been shown that psychosocial dimensions must be taken into account when facing the contagion from COVID-19.

La pandemia del COVID-19 requiere comprender diferentes aspectos que condicionan la formación de la percepción social sobre este fenómeno. El objetivo de este estudio fue identificar las variables psicosociales que predicen la adopción de la creencia de que el aislamiento social previene el contagio de COVID-19. Se realizó un estudio correlacional, en el que 498 participantes con una edad promedio de 34,9 años respondieron un cuestionario online. Los instrumentos de investigación fueron: un cuestionario sociodemográfico, escalas de actitudes y creencias en salud. Se utilizaron análisis descriptivos, correlaciones y análisis de regresión lineal múltiple. Los resultados demostraron que las actitudes políticas contribuyen a la formación de la creencia sobre el aislamiento social en el contexto de COVID-19. Las interrelaciones han demostrado que las identidades políticas desempeñan un papel importante en la adhesión a los discursos de las instituciones sanitarias o las instituciones políticas. Se evidencia que hay que tener en cuenta las dimensiones psicosociales cuando se trata del contagio del COVID-19.

Contexts, beliefs and health behaviour: Are individuals who engage in risky sexual behaviour likely to wear face-masks against COVID-19?

and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context-dependent based on the individual's beliefs. To investigate whether or not individuals' protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases

Creencias relacionadas al cuidado de la salud oral en cuidadores de adultos mayores institucionalizados de la ciudad de Antofagasta, Chile, 2019

Resumen Objetivo: analizar las creencias relacionadas al cuidado de la salud oral en cuidadores de adultos mayores institucionalizados de la ciudad de Antofagasta, Chile, 2019. Material y Métodos: Estudio cuantitativo, observacional, descriptivo, transversal. Se entrevistó a 49 cuidadores con el cuestionario DCBS-sp, para determinar sus creencias relacionadas al cuidado de la salud oral. Para análisis estadístico se utilizó STATA 14 ®. Resultados: El 36,73% tiene capacitación en salud oral y el 97,96%, percibe la necesidad de capacitarse. Cuidadores con capacitación tienen significativamente más puntajes promedio favorables a la salud bucal en las dimensiones locus control interno y autoeficacia. Conclusiones: Cuidadores tienen baja capacitación para el cuidado de la salud bucal, existiendo creencias desfavorables al cuidado de la salud bucal de las personas mayores institucionalizados. Es necesario diseñar intervenciones de educación para la salud bucal en este grupo que permitan mejorar las creencias relacionadas al cuidado de la salud oral.

Resumo Objetivo: analisar as crenças relacionadas à atenção à saúde bucal em cuidadores de idosos institucionalizados na cidade de Antofagasta, Chile, 2019. Materiais e Métodos: Estudo quantitativo, observacional, descritivo, transversal. 49 cuidadores foram entrevistados com o questionário DCBS-sp para determinar suas crenças relacionadas aos cuidados com a saúde bucal. Para análise estatística, foi utilizado o STATA 14 ®. Resultados: 36,73% possuem treinamento em saúde bucal e 97,96% percebem a necessidade de treinamento. Cuidadores treinados apresentam escores médios significativamente mais elevados favoráveis ​​à saúde bucal nas dimensões de controle do locus interno e autoeficácia. Conclusões: Os cuidadores apresentam baixa formação para os cuidados com a saúde bucal, há crenças desfavoráveis ​​em relação aos cuidados com a saúde bucal de idosos institucionalizados. É necessário desenhar intervenções de educação em saúde bucal nesse grupo para melhorar as crenças relacionadas aos cuidados com a saúde bucal.

Abstract Objective: to analyze oral health care related beliefs among caregivers of the institutionalized elderly in Antofagasta, Chile, 2019. Material and methods: A quantitative, observational, descriptive, cross-sectional study was conducted. Forty-nine caregivers were interviewed with the DCBS-sp questionnaire to determine their oral health care beliefs. STATA 14® was used to conduct the statistical analysis. Results: Of the caregivers interviewed, 36.73% have oral health training, and 97.96% feel they need training. Trained caregivers have significantly better average oral health scores on internal locus of control and self -efficacy. Conclusions Caregivers have insufficient oral health training, and there are unfavorable beliefs about the oral health care of the institutionalized elderly. It is necessary to design oral health educational interventions to allow this group of professionals to improve their oral health care related beliefs.

Knowledge, Health Beliefs and Osteoporosis Preventive Behaviour Among Women of Reproductive Age in Egypt

@#Introduction: : Osteoporosis is an important, global public health issue that is expected to become an epidemic by 2050, and particularly affect an increasing number of elderly women worldwide. The current study was designed to measure the current osteoporosis knowledge level among a sample population of women, to assess osteoporosis health beliefs, and assess osteoporosis preventive measures and factors related to those taking preventive measures. Methods: A cross-sectional study was conducted, using multistage sampling. A total of 265 women were randomly selected among those attending outpatient clinics in primary health care units. The study used a questionnaire to assess knowledge, health beliefs, in addition to osteoporosis preventive behaviour. Results: About 59% of the participants showed inadequate knowledge and 70.7% had inadequate osteoporosis preventive behaviour. Inadequate knowledge levels were more common among the younger participants, and those with a lower educational level, absence of osteoporosis in first degree relatives and no history of fractures. Significant differences were observed in the mean score of overall health beliefs and all its sub-scales, except for perceived exercise benefits and perceived health motivation. Sub-optimal calcium intake levels were noted, but were significantly higher among those with adequate osteoporosis preventive behaviour than among those with inadequate osteoporosis preventive behaviour (907.2 ± 187.6 and 810.7 ± 123.3, respectively, p < 0.001). Conclusions: The sample of women under investigation showed unsatisfactory levels of knowledge regarding osteoporosis, substandard health beliefs and sub-optimal levels of calcium consumption. Community-based interventions should be conducted to overcome the barriers to adopting preventive behaviours.

Analysis of Factors Affecting Breakfast Eating Behavior of Children in Indonesia: An Application of the Health Belief Model / 대한지역사회영양학회지

OBJECTIVES: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior.METHODS: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR).RESULTS: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children.CONCLUSIONS: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.

Escala del Modelo de Creencias de Salud para la Autoexploración de Mama en Estudiantes Universitarias / The Health Beliefs Model Scale for Breast Self-Examination in University Students

Resumen El objetivo de este estudio fue adaptar la escala del modelo de creencias de salud para la autoexploración de mama (AEM) en estudiantes universitarias y determinar su validez y confiabilidad. La escala de modelo de creencias de salud sobre la AEM de 39 ítems fue aplicada en 994 estudiantes de licenciatura. La confiabilidad se evaluó a través del Alfa de Cronbach, la validez de constructo mediante el Análisis Factorial Exploratorio. Se detectó una estructura de 6 factores con un valor de Kaiser-Meyer-Olkin de .839 y la prueba de esfericidad de Bartlett fue significativa [χ2(496)= 5379.608, p<.0001]. Los factores tuvieron valores de consistencia interna entre .67 a .87. Por lo que se concluye que la escala del modelo de creencias para la AEM en mujeres jóvenes mexicanas presenta la misma estructura factorial que la original siendo válida y confiable para propósitos de investigación.

Abstract The objective of this study was to adapt the health belief model scale for breast self-examination (BSE) in university students and determine its validity and reliability. The health beliefs model scale of 39 items was applied in 994 undergraduate students. Reliability was assessed through Cronbach's Alpha, construct validity through Exploratory Factor Analysis. A structure of six factors with a Kaiser-Meyer-Olkin value of .839 was detected and Bartlett's Sphericity Test was significant [χ2 (496) = 5379.608, p <.0001]. The factors had internal consistency values between .67 and .87. Therefore, it can be concluded that the belief model scale for BSE in young Mexican women presents the same factorial structure as the original, being valid and reliable for research purposes.

Crenças em saúde acerca do exame do toque retal / Health beliefs about the digital rectal exam / Creencias en salud acerca del examen del toque rectal

Este trabalho buscou identificar as principais crenças de homens acerca do Exame do Toque Retal (ETR), comparando as respostas de homens que o fizeram (G1) e dos que ainda não o fizeram (G2). Utilizou-se um questionário sociodemográfico e clínico, além da técnica de evocação de palavras. No G1, as evocações relacionadas à suscetibilidade, gravidade e benefícios do exame foram mais enfatizadas. Já no G2, destacaram-se as crenças voltadas à suscetibilidade e aos benefícios de realizar o exame. Os dados encontrados sugerem que fazer o ETR pode reforçar alguns estereótipos em relação aos aspectos negativos do exame, porém não anula os aspectos positivos. Deve-se levar em consideração a relação paciente-profissional, bem como a condução do profissional durante a realização do ETR, já que barreiras podem estar sendo reforçadas nessa situação. Enfim, aponta-se para a necessidade de trabalhar a temática da busca pelo ETR não só com a população-alvo, mas também com os profissionais de saúde

This study aimed to identify the main male beliefs about the Digital Rectal Exam (DRE) comparing the responses of men who did the exam (G1) and those who did not (G2). We used a questionnaire containing sociodemographic and clinical variables, as well as free evocations. G1 showed evocations related to the susceptibility, severity, and beliefs associated with the benefits of the exam. Among G2, beliefs about susceptibility and benefits of screening were also highlighted. The results suggest that doing DRE may reinforce some stereotypes regarding negative aspects of the examination, but they do not cancel its positive aspects at all. It is necessary to take care of the patient-professional relationship and the professional's conduct during DRE, since barriers might be strengthened in that situation. Finally, we believe it is important to clarify the perception of searching for DRE not only with the target population, but also with health professionals

Este trabajo buscó identificar las principales creencias de hombres acerca del Examen del Toque Retal (ETR), comparando las respuestas de hombres que lo hicieron (G1) y de los que aún no lo hicieron (G2). Se utilizó un cuestionario sociodemográfico y clínico, además de la técnica de evocación de palabras. En el G1, las evocaciones relacionadas con la susceptibilidad, gravedad y beneficios del examen, fueron más enfatizadas. En el G2, se destacaron las creencias volcadas a la susceptibilidad y a los beneficios de realizar el examen. Los datos encontrados sugieren que hacer el ETR puede reforzar algunos estereotipos en relación a los aspectos negativos del examen, pero no anula los aspectos positivos. Se debe tener en cuenta la relación paciente-profesional, así como la conducción del profesional durante la realización del ETR, ya que las barreras pueden estar siendo reforzadas en esa situación. En fin, se apunta a la necesidad de trabajar la temática de la búsqueda por el ETR no solo con la población objetivo, sino también con los profesionales de salud

Beliefs about childhood cancer: perceptions of survivors and mothers / Crenças sobre o câncer infantil: percepção de sobreviventes e mães / Creencias sobre el cáncer en niños: percepción de sobrevivientes y madres

Beliefs regarding a disease refer to mental schemes people construct based on their direct or indirect experiences and that are related to their health behavior and self-regulation. Such beliefs help childhood cancer survivors understand their behavior in their follow-up treatment. This study's purpose was to examine the beliefs concerning childhood cancer among 27 survivors and 49 mothers, who completed sociodemographic surveys and questionnaires addressing disease perceptions via an online platform. Results reveal that mothers, more frequently than survivors, perceived childhood cancer as a chronic disease with cyclical symptoms, with more negative consequences and emotional representations. The mothers also reported having greater understanding regarding the disease and more strongly believed in personal and treatment control in comparison to survivors. The conclusion is that the fact that survivors more positively perceived childhood cancer may indicate they re-signified their experiences in an adaptive manner.

As crenças sobre a doença referem-se a esquemas mentais que as pessoas constroem a partir de sua experiência direta ou indireta e que se relacionam com o seu comportamento em saúde e autorregulação. Em sobreviventes de câncer infantil, as crenças ajudam a compreender seus comportamentos no período pós-tratamento. Objetivou-se examinar as crenças sobre o câncer infantil em 27 sobreviventes e 49 mães que responderam a questionários sociodemográficos e de percepção da doença numa plataforma on-line. Os resultados apontaram que as mães perceberam o câncer infantil como uma doença crônica, com sintomas cíclicos, com consequências e representação emocional mais negativas que os sobreviventes. Ainda, as mães referiram compreender os aspectos relacionados à doença e acreditam no controle pessoal e do tratamento num nível mais elevado que os sobreviventes. Conclui-se que o fato de os sobreviventes perceberem o câncer infantil de maneira mais positiva pode indicar uma ressignificação da experiência de forma adaptativa.

Las creencias sobre la enfermedad se refieren a esquemas mentales que las personas construyen a partir de su experiencia directa o indirecta y que se relacionan con su conducta en salud y autorregulación. En sobrevivientes de cáncer en la niñez, sus creencias ayudan a comprender sus conductas en el periodo post-tratamiento. El objetivo fue examinar las creencias sobre el cáncer en la niñez en 27 sobrevivientes adultos jóvenes y 49 madres que contestaron a cuestionarios sociodemográfico y de percepción de la enfermedad en un sitio web. Los resultados mostraron que las madres percibieron el cáncer en la niñez como una enfermedad crónica, con síntomas cíclicos, con consecuencias y representación emocional más negativa que los sobrevivientes. Además, las madres refirieron comprender la enfermedad y creer en el control personal y del tratamiento a un nivel más alto que los sobrevivientes. Se concluye que el hecho de que los sobrevivientes perciban el cáncer en la niñez de manera más positiva pueda indicar una nueva significación de la experiencia de manera positiva.

Health Beliefs Predict Self-Care Practices And Glycaemic Control In Malaysian Patients With Insulin-Treated Diabetes: A Longitudinal Study

@#The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.

Cardiovascular Disease–related Health Beliefs and Lifestyle Issues Among Karen Refugees Resettled in the United States From the Thai-Myanmar (Burma) Border / 예방의학회지

OBJECTIVES: Refugees resettled in the US may be at risk for cardiovascular disease (CVD). However, little is known about CVD-related issues among Karen refugees who have migrated to the US from the Thai-Myanmar border. The purpose of this study was to examine CVD-related health beliefs and lifestyle issues among Karen refugees resettled in the US. METHODS: Karen refugees resettled in the US from the Thai-Myanmar border (n=195) participated in a survey study on health beliefs related to CVD, salt intake, physical activity (PA), and smoking in the fall of 2016. RESULTS: A high-salt diet, physical inactivity, and smoking were major lifestyle problems. Participants who adhered to a low-salt diet considered themselves to be susceptible to CVD. Most participants did not engage in regular PA. Regular PA was associated with less perceived susceptibility to CVD and greater perceived benefits of a healthy lifestyle for decreasing the likelihood of CVD. CONCLUSIONS: Each refugee population may require individualized strategies to promote PA and a healthy diet. Future studies should develop health education programs that are specifically designed for Karen refugees and evaluate such programs. In addition to health education programs on healthy lifestyle choices, tobacco cessation programs seem to be necessary for Karen refugees. At the same time, it is important to foster strategies to increase the utilization of preventive care among this population by promoting free or reduced-fee resources in the community to further promote their health.

Motivos e crenças de familiares frente ao tratamento do transtorno depressivo na infância: estudo qualitativo / Statements and beliefs of family face of treatment of depressive disorder in childhood: qualitative study / Declaración y creencias de la família ante el tratamento del transtorno depressivo en la infancia: estudo Cualitativo

Objetivou-se nesta pesquisa analisar os processos e as motivações que levaram os pais e responsáveis à percepção da depressão em suas crianças e à consequente procura de cuidado especializado, além de compreender a influência das crenças em saúde e dos hábitos culturais na procura de tratamento. Foram analisadas cinco entrevistas realizadas em um ambulatório de psiquiatria de um hospital universitário estatal. Utilizou-se metodologia qualitativa, estudo de caso, sob-referencial teórico do "Modelo de Crenças em Saúde". O estigma acerca da psiquiatria e loucura; a não aceitação da existência de depressão em crianças; o desconhecimento acerca da depressão e seus sintomas e as dificuldades diagnosticadas nesta idade são exemplos de fatores que retardam a procura ao tratamento. Em contrapartida, o conhecimento prévio acerca da doença; a ação de profissionais de saúde e educadores e a crença na efetividade do tratamento psiquiátrico possibilitam início precoce do tratamento.

The objective of this research was to examine the processes and motivations that lead parents and caregivers to the perception of depression in their children and the consequent demand for specialized care and understand the influence of health belief and cultural habits in seeking treatment. We analyzed interviews conducted in five psychiatric outpatient clinic in a state university hospital, 2005. We used qualitative methodology - case study - under the theoretical reference of the "Health Belief Model". The stigma about psychiatry and madness; not accepting the existence of depression in children; ignorance about depression and its symptoms and the diagnostic difficulties in this age are examples of factors that delay seeking treatment. In contrast, the prior knowledge about the disease, the action of health professionals and educators and the belief in the effectiveness of psychiatric treatment, allow early treatment.

El objetivo de esta investigación era examinar los procesos y las motivaciones qué llevan a los padres y cuidadores a la percepción de la depresión en sus hijos y la consiguiente demanda de atención especializada y comprender la influencia de las creencias y los hábitos culturales en la búsqueda de tratamiento. Se utilizó metodología cualitativa - estudio de caso - e referencia teórica del "Modelo de Creencias en Salud". El estigma de la psiquiatría y la locura; no aceptar la existencia de la depresión en niños; la ignorancia acerca de la depresión y sus síntomas y las dificultades de diagnóstico en esta edad son ejemplos de factores que retardan la busca de tratamiento. Por el contrario, el conocimiento previo acerca de la enfermedad, la acción de los profesionales sanitarios y educadores y la creencia en la eficacia del tratamiento psiquiátrico propician el tratamiento temprano.

Adherencia terapéutica y creencias sobre su salud en pacientes hipertensos / Therapeutic adherence and beliefs about health in hypertensive patients

Se realizó un estudio descriptivo, cuantitativo y transversal de 45 pacientes con hipertensión arterial, pertenecientes al consultorio médico "21 de mayo" del municipio de Media Luna, provincia de Granma, desde septiembre de 2013 hasta mayo de 2014, con vistas a determinar la adherencia terapéutica y las creencias sobre su salud en los afectados. Predominaron los pacientes con adherencia parcial al tratamiento, susceptibilidad percibida baja y severidad percibida media ante las complicaciones de la hipertensión arterial; los encuestados con beneficios en su terapia, quienes encontraron muchas barreras para cumplir con las indicaciones de su médico. Las dificultades presentadas en la adhesión al tratamiento se correspondieron con la susceptibilidad y severidad percibidas ante las complicaciones de la citada afección, así como con los beneficios y barreras del tratamiento antihipertensivo.

A descriptive, quantitative and cross-sectional study of 45 patients with hypertension, belonging to "21 Mayo" doctor's office from Media Luna municipality, Granma province was carried out from September, 2013 to May, 2014, with the aim of determining the therapeutic adherence and beliefs about their health in the affected patients. Patients with partial adherence to the treatment, low perceived susceptibility and mean perceived severity when facing the complications of hypertension; those interviewed with benefits in their therapy who found many barriers to fulfil their doctor's indications prevailed. The difficulties presented in the adhesion to the treatment were in correspondence to the susceptibility and severity perceived when the complications of the mentioned disorder were present, as well as with the benefits and barriers of the antihypertensive treatment.

Creencias en salud oral de cuidadores de pacientes discapacitados y adultos mayores institucionalizados de la comuna de Quilaco, Región del Biobío / Oral health beliefs in caregivers of institutionalized disabled and elderly patients of the Quilaco commune, Biobío Region

El envejecimiento demográfico acelerado de la población de Chile supone un aumento en la prevalencia no solo de enfermedades crónicas, sino también de personas con discapacidad, y necesidad de ser cuidadas en forma permanente. En este sentido, tomando como grupo de estudio a los cuidadores de los adultos mayores institucionalizados de la comuna de Quilaco, Región del Biobío, analizamos las creencias en salud oral que los cuidadores poseen al momento de llevar a cabo la atención de los adultos mayores que se encuentran a su cargo.

The rapid aging of the population of Chile will produce an increase not only in the prevalence of chronic diseases, but also of people with disabilities, and their need to be cared for permanently. In this sense, taking the caregivers of the institutionalized elderly population of the Quilaco commune, Biobío Region, as a study group, we analyzed the oral health beliefs that caregivers have at the time of undertaking the care of older adults.

The Relevant Intervention Strategies for Improving Medication Adherence of Diabetic Patients

Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent’s health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent’s related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.

Tejiendo explicaciones sobre vejez,discapacidad y pobreza en los cerrosnororientales de Bogotá, Colombia / Knitting Answers for Disabilities, Poverty and the Elderly of the Northeastern Hills in Bogotá, Colombia / Tecendo explicações sobre a velhice, invalidez e pobreza nas colinas orientais de Bogotá, Colômbia

Introducción: Los juicios sobre las diversas situaciones de salud que realizan las personas ancianas en situación de discapacidad y pobreza no son similares a las de los profesionales de salud. Estas explicaciones son producto de las construcciones culturales, del contexto y de las experiencias de cuidado. Objetivo: Explorar las explicaciones que dan a su situación las personas ancianas en situación de discapacidad y pobreza habitantes de cinco barrios de los cerros nororientales de Bogotá. Método: Estudio cualitativo etnográfico. Se seleccionaron 39 colaboradores mayores de 60 años, en quienes se realizó observación participante y entrevistas etnográficas en sus lugares de residencia. Resultados: Se reconocieron las explicaciones que dan las personas a su situación, denominada comprensión de la situación de salud, que empieza por admitir las manifestaciones de bienestar o malestar, nominar la situación, darle un significadoy establecer unas relaciones causales (de origen psicosocial, socioeconómico y natural). Conclusiones: Las explicaciones que los colaboradores de este estudio atribuyen a su situación, a la cual denominan males, demuestran complejidad y multicausalidad. Estas construyen una especie de tejido que genera una lógica interna que ayuda a las personas a dar sentido a sus vivencias cuando presentan situaciones de salud adversas. Las enfermeras deberán prepararse para brindar un cuidado culturalmente congruente, que reconozca los saberes, las creencias y las prácticas de las personas ancianas, a fin de generar conocimiento, planes y estrategias, dirigidos al cuidado particularizado, acorde con la diversidad de la población...

Introduction: Thoughts on the diversity of health situations performed by elderly, disabled people are usually not the same as those thoughts performed by health professionals; their explanations are more likely the product of cultural and contextual constructions, and of previous health care experiences. Main purpose: Exploring the explanations given by elderly people in disability and poverty –dwellers of five neighbourhoods on the Northeastern hills of Bogotᖠto their situation. Method: Ethnographic- qualitative survey. Thirty-nine volunteers older than 60 were chosen; participant observation and ethnographic interviews took place inside their dwelling places. All the information was recorded, transcribed and organized following the proposal of M. Leininger. It was later analysed using the Cultural Care Adversity Theory and the Minayo proposals, among others. Results: explanations made by this age and social group appeared, receiving the name “Understanding health situation” and recognizing manifestations of welfare or discomfort. It was also able to name the situation, give it a meaning and establish cause relations (with psychosocial, socioeconomic and natural origins) in order to try and explain the situation. Conclusions: explanations given by our volunteers to situations called Males by them, show a big amount of complexity and multi-causality. Through these explanations they build a sort of knitting with its own internal logics that helps them in giving sense to their adverse-health experiences Thus, nurses should prepare themselves to perform a culturally coherent care, a careable to acknowledge wisdom, beliefs and practices of the elderly in order to contribute tothe production of knowledge, strategies and plans aimed at particularized health-care,congruent to the population’s diversity...

Introdução: Julgamentos sobre as diversas situações de saúde que fazem os idosos em situações de deficiência e pobreza não são semelhantes às dos profissionais de saúde, essas explicações são produto de construções culturais, no contexto das experiências de cuidado. Objetivo: Explorar as explicações dadas à sua situação em idosos com deficiência e pobreza, residentes em cinco bairros de colinas orientais de Bogotá. Método: Estudo etnográfico qualitativo. Foram selecionados 39 participantes com mais de 60 anos. Foi realizada a observação participante e entrevistas etnográficas nos locais de residência destes. Resultados: Foram reconhecidas as explicações que as pessoas dão à sua situação, que é chamada entendendo a situação de saúde, que começa por reconhecer as manifestações de conforto ou desconforto, nomear a situação, dar sentido e estabelecer relações causais (de origens psicossociais, socioeconômicos e naturais), a fim de explicar a situação. Conclusões: As explicações que os participantes deste estudo atribuíram a sua situação, e que eles chamam males, demonstram complexidade e múltiplas causas. Eles construíram uma espécie de tecido que gera uma lógica interna que ajuda as pessoas a dar sentido a suas experiências quando têm situações adversas à saúde. Enfermeiros devem estar preparados para prestar cuidados culturalmente congruentes, ou seja, o cuidado que reconhece o conhecimento, crenças e práticas dos idosos, a fim de contribuir para a geração de conhecimentos, planos e estratégias, visando à atenção particularizada, segundo a diversidade da população...