A questionnaire-based study to assess knowledge and attitudes to meningococcal disease and prevention among parents of children up to two years in Lithuania.

OBJECTIVES: In July 2018, vaccine against meningococcal B infection in Lithuania was added to the national vaccination calendar. However, vaccination rates were low. The aim of the study was to identify parents' attitudes towards meningococcal disease and vaccination. METHODS: In the period from February to March 2019, a questionnaire survey was conducted; 483 parents of children aged up to 2 years participated. In the validated questionnaire respondents provided data on their gender, education, age and answered questions that helped to estimate knowledge and attitudes towards meningococcal disease and vaccination. RESULTS: Parents with higher education are more likely to believe that meningococcal infection can be prevented; 316 (65.4%) parents are concerned that their child is at high risk of infection and evaluated the level of anxiety M = 7.39, SD = 2.29 out of 10 points; 309 (64.0%) believe that the vaccine is effective (M = 8.41; SD = 1.15 out of 10 points). One third of parents will not vaccinate their children because they believe that the MenB vaccine is not safe (71.2%); 370 (76.6%) have heard negative information about this vaccine, the majority (83.2%) from the Internet. The negative information received is positively correlated with the belief that the vaccine is not effective (r = 0.18, p = 0.031) and not safe (r = 0.35, p < 0.001); 49.3% of parents report side effects after vaccination; 326 (67.5%) parents believe that they need more evidence-based information on MenB vaccination and 90.8% would like to get it from a healthcare professional. CONCLUSIONS: Due to high level of mistrust of vaccines and the lack of evidence-based information, parents decide not to vaccinate their children against meningococcal B infection. There is a great need for parents' education and the dissemination of evidence-based information among them.

Self-rated health among physicians.

The aim of the study was to analyze self-rated health among physicians depending on their sex, age, workplace (hospital or polyclinic), and specialty. MATERIAL AND METHODS. The studied group consisted of 377 26-70-year-old physicians randomly selected from various county hospitals and polyclinics of Lithuania. There were 85 men and 292 women. The inquiry was performed using the complemented (by the authors of the study) version of the WHO anonymous questionnaire of the quality of life (1995). Responses were evaluated based on physicians' evaluation of their own health, which was rated as very good, good, satisfactory, poor, and very poor. RESULTS. Only 8.2% of males and 5.8% of females evaluated their health as very good (P>0.05). More men, compared to women, evaluated their health as good (62.3% and 53.1%, respectively; P<0.05), whereas more females evaluated their health as satisfactory, compared to males (36.0% and 25.9%, respectively; P<0.05); 2.4% of males and 5.1% of females (p>0.05) stated that their health was poor. In most cases, physicians of different age groups presented equal evaluations of their health except for physicians in the age groups of 26-37 and 38-43 years - those who evaluated their health as very good comprised a significantly higher percentage (P<0.05), compared to other age groups. As expected, a higher percentage of older physicians evaluated their health as satisfactory. In addition to that, more hospital physicians, compared to those working in polyclinics, evaluated their health as good (12.8% and 1.8%, respectively; P<0.05) and vice versa - significantly more physicians working in polyclinics evaluated their health as satisfactory, compared to those working in hospitals (38.1% and 26.8%, respectively; P<0.05). A significantly higher percentage of surgeons, compared to general practitioners or therapists, evaluated their health as very good (15.8%, 4.5%, and 6.1%, respectively; P<0.05) and a significantly lower percentage - as satisfactory (P<0.05). CONCLUSIONS. Irrespectively of sex, 6.4% of the studied physicians evaluated their health as very good; 55.2%, as good; 33.7%, as satisfactory; 4.7%, as poor; and 0.3%, as very poor. A higher percentage of physicians who evaluated their health as very good or good were 26-37 and 38-43 years of age, whereas more physicians in older age groups evaluated their health as satisfactory. A higher percentage of physicians working in hospital evaluated their health as very good, whereas more physicians who worked in polyclinics evaluated their health as satisfactory. Compared to general practitioners and therapists, surgeons more frequently evaluated their health as very good and significantly less frequently - as satisfactory.

Satisfaction with organizational aspects of health care provision among Lithuanian physicians.

BACKGROUND: Physician satisfaction is considered an important factor influencing quality of health care provision, patient compliance, and costs to health care systems. Dissatisfaction leads to an increase in turnover of physicians and early retirement, which has a negative impact on continuity and quality of health care. Physician dissatisfaction with certain aspects of health care provision may also help to identify potential weaknesses in satisfactory functioning of health care systems. The aim of the current research project is to study the satisfaction with different organizational aspects of health care provision in Lithuania as judged by a selection of physicians. METHOD: The study was conducted in Lithuania in June 2004. Physicians in randomly selected health care centers were invited to take part in the survey, 505 primary and secondary care physicians were interviewed by external interviewers during the study period. Physicians were asked to express their satisfaction on items presented in a questionnaire. The questionnaire consisted of 22 questions, evaluating different aspects of health care services - working conditions, workload, financial remuneration, organization of health care infrastructure and availability of laboratory services. Answers were presented by the 5 point Likert type scale, ranging from "very satisfied" (5) to "very dissatisfied" (1). RESULTS: Physicians who were most satisfied with their working conditions were working in private primary health care practices (91.1% satisfied or very satisfied), as compared with 54% of physicians working in state-owned primary care institutions and 49.7% in hospitals. Physicians working in cities and regional centers or towns were more satisfied with organizational aspects of health care services than physicians working in rural health care centers. Satisfaction with their financial remuneration showed that 74% of respondents stated they were "dissatisfied" or "very dissatisfied". While asked about potential deficiencies in their health care institutions, the most important identified by respondents in all localities was a perceived lack of financial support for these institutions. CONCLUSIONS: There is a significant difference in the perception of physicians in private and state health care institutions with regard to financial remuneration as well as availability of laboratory diagnostic and treatment equipment and working conditions. Based on the study findings, possibilities to increase Primary Care financing should be considered in order to improve the quality of the delivery of health care services as well as retain physicians within the health care system. Results of this study demonstrate a need of further research to quantify what could be reasonably expected from diagnostic and investigative resources to support health care in Lithuania in current economic situation.

[Influence of patient's social and demographic characteristics on patient's expectations for medical consultation]. / Paciento medicinines konsultacijos lukesciu priklausomumas nuo socialiniu bei demografiniu paciento charakteristiku.

UNLABELLED: Most of the patients, coming to see their primary care physician, have explicit expectations and priorities for the medical consultation. Recognition of these expectations is an important step in organizing patient-oriented health care services. Patient expectations depend on a number of factors: health problem and its severity, as well as social and demographic characteristics of patient and physician. Objective of this survey was to evaluate influence of patient's socio-demographic characteristics and some health status indicators on expectations for primary care consultation. MATERIAL AND METHODS: During the study 403 patients and 162 physicians were surveyed. Pre-visit expectations of patients coming to see their primary care physician for health problem were investigated using self-addressed original questionnaire. RESULTS: Factor analysis revealed three main factors: biomedical expectations, emotional support expectations and expectations for partnership. Analysis of influence of socio-demographic characteristics on patient expectations showed that statistically significant differences in different age groups were found only for emotional support factor. Patients' desire for emotional support from doctor increased with age. Relationship was observed between expectations for emotional support and health status as perceived by patient. Patients evaluating their health problem as not serious had mean score of expectations for emotional support 3.4, patients with moderate health problem--3.5, patients with serious health problem--4.0 out of 5. CONCLUSIONS: Patient's need for emotional support from physician depends on his age, marital status, frequency of his visits to physician during the year, self-perception of the health status and course of disease. Analysis of relationship between patient's expectations and his sex, education, physician's sex or type of practice did not show statistically significant differences between groups. No influence of analyzed social and demographic characteristics or perceived health status on biomedical expectations (laboratory tests, specialist consultations, and hospital treatment) was found during our study.

[Evaluation of patient needs and quality of outpatient health care services in large cities, district centers, villages and townships of Lithuania]. / Ambulatorines sveikatos prieziuros paslaugu poreikio bei kokybes vertinimas Lietuvos didziuosiuose miestuose, rajonu centruose, kaimuose bei miesteliuose.

Opinion of patients concerning some aspects of patient needs and quality of ambulatory care services was investigated by survey, performed in ambulatory health care institutions of Lithuania in May, 2002. Results of survey included comparison of patient opinion in cities, regional centers, villages and townships. Representative number of 1003 inhabitants was selected as a study sample. Inhabitants were interviewed by means of standardized questionnaire developed by study team. According to the results of survey, patients evaluate changes in quality of the health care services more negatively that positively. Positive changes, by opinion of respondents, were in physician attitudes towards patient, this opinion was supported by 27% of respondents. Most negative changes, reported by patients, were changes in management of health care institutions, including functioning of registration office. Forty percent of inhabitants, participating in the study, expressed the opinion that accessibility of consultant services became more complicated, 35% did not notice any changes, 15% thought that procedure became easier; 38% of respondents thought that accessibility to ambulatory health care services worsened. Respondents also had different opinions concerning development of institution of family physician; 45% evaluated it as a positive change in health care system, and 42% expressed negative opinion. Main problems in functioning of ambulatory care institutions, by opinion of respondents, are long queues at the physician office, difficulties in registration in advance and out-of-pocket payments to physicians.

[Accessibility of health care: evaluation of the performance of the city of Vilnius Seskines outpatient clinic]. / Sveikatos prieziuros paslaugu prieinamumas. Vilniaus miesto Seskines poliklinikos darbo ivertinimas.

INTRODUCTION: The purpose of this study was to determine the reasons of the queues, which patients meet in clinic and to determine the spent time of patients in different places of clinic. We wanted to figure out the opinion of patients about the work of the personnel, to find the ways of reducing the queues in the clinic. METHODS: Study was done in November 2000-January 2001. Total or 1000 questionnaires were given to every third visitor over the age of 16. After return of 67.8% of questionnaires, 222 new questionnaires were sent to people, who didn't answer the first time. The overall response rate was 77.8%; 40 questionnaires were inapplicable for study, therefore a sample of 738 respondents was studied. Statistic data analysis was made using SPSS for Windows. The differences between respective indexes were assumed as statistically significant, then the mistake probability was p < or = 0.05. RESULTS: The aim of our study--to determine the time spent in different places of clinic, and to figure out patient's opinion about work of the personnel. In registry office every patient spent on average 16 minutes. Every patient spends on average 30 minutes waiting to doctor. Consultations via telephone different groups of respondents evaluated differently: the older the patient, the worse his attitude towards consultation. Besides the fact, that 40% of elderly respondents are benevolent to consultations by the telephone, they assume, that they wouldn't use such kind of service. Waiting time for procedures, is on average 17 minutes. In all cases we can say, that the more patients face the queues, the more they think, that those queues should not exist. But the majority of respondents meet the queues very rarely, and most of them think, that the queues are imperative, or at least short waiting is inevitable.