ABSTRACT
OBJECTIVES: Findings have shown that many people do not seek help when experiencing psychological distress. The main aim of this paper is to examine the socio-demographic and health status factors that predict help seeking for self-reported mental health problems for males and females from a general practitioner (GP). DESIGN: The analysis used data from the HRB National Psychological Wellbeing and Distress Survey - a telephone survey of the population aged 18 years and over. METHODS: Telephone numbers were selected on a random probability basis. An initial set of random clusters was selected from the Geodirectory. Using these sampling areas, random digit dialling was used to generate a random telephone sample. Data were weighted on key variables. Respondents who reported mental health problems in the previous year were included in the current study (382/2,674). RESULTS: The findings showed gender differences in the models of predictors between males and females with more factors influencing attendance at the GP for males than for females. While only social limitations and access to free health care predicted female attendance, a range of socio-demographic and psychological factors influenced male attendance. CONCLUSIONS: Findings suggest that a 'gender sensitive approach' should be applied to mental health policies and mental health promotion and prevention programmes. Acknowledgement and awareness of the factors that influence help seeking will aid the design of gender specific promotion, prevention, and treatment programmes at primary care level.
Subject(s)
Health Behavior , Health Services Accessibility/statistics & numerical data , Mental Disorders/psychology , Physicians, Family , Self Disclosure , Adaptation, Psychological , Adolescent , Adult , Age Distribution , Female , Health Status , Humans , Interviews as Topic/methods , Male , Mental Disorders/complications , Mental Disorders/therapy , Middle Aged , Quality of Life/psychology , Self Concept , Sex Distribution , Socioeconomic Factors , Stress, Psychological/complications , Stress, Psychological/psychology , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: In rural areas it is impossible for eligible patients presenting with acute myocardial infarction (AMI) to receive thrombolysis within the recommended 90 minutes unless administered in the community by the general practitioner. AIMS: The aim of this study was to describe the attitudes of hospital staff and general practitioners towards pre-hospital administration of thrombolysis. METHOD: General practitioners, consultant physicians and nursing staff participated in the survey. RESULTS: General practitioners were convinced of the added benefits of administration of thrombolysis in the community and believed the hospital had a role to play. Likewise the hospital staff agreed with the benefits of pre-hospital thrombolysis. However, they felt that the decision to thrombolyse patients should be made in consultation with the hospital. CONCLUSIONS: Pre-hospital thrombolysis programmes must be continuously monitored and evaluated to identify important factors that may prevent wider use of thrombolytic treatment.
Subject(s)
Attitude of Health Personnel , Emergency Treatment , Myocardial Infarction/drug therapy , Physicians, Family , Rural Health Services , Thrombolytic Therapy , Decision Making , Humans , IrelandABSTRACT
The Cardiovascular Health Strategy recommended that patients presenting with acute myocardial infarction receive thrombolysis within ninety minutes of alerting medical or ambulance services. The aim of this prospective study was to describe the management of patients with acute myocardial infarction (AMI) presenting to a district general hospital in Donegal. All patients with a confirmed diagnosis of acute myocardial infarction, excluding those from the Donegal Area Rapid Treatment Study (DARTS) practices, admitted to Letterkenny General Hospital (LGH) from 31.08.99 to 31.08.01 were included in the study. 349 patients were included in the study; average age of 68 ranging from 30 to 96 years and 69% were male. Of the 349 patients, 101 (29%) were located more than 30 miles from LGH at the time of onset of symptoms. The median time taken from the onset of symptoms to calling for help was 119 minutes. The median time from hospital arrival to patients being admitted to CCU was 90 minutes. Thrombolytic therapy was administered in 31% of patients; for these patients the median call to needle time was 200 minutes. Call to needle times differed significantly between rural (median 227.5 minutes n = 64) and urban patients (median 175 minutes n = 37, p < 0.05, Mann-Whitney). Hospital delay times decreased throughout the study period (p > 0.05, Mann-Whitney). The study extends the findings from previous research by investigating the individual time delay components from onset of symptoms to treatment in AMI patients. Delay times exceed the recommended call to needle and door to needle times suggesting the need for interventions to reduce these times.
