卫生保健需要的重要性与意义

卫生保健需要在卫生计划和资源配置中的作用日益受到重视。卫生保健需要是有层次的,相对的,因确定者,不同个体以及时间而异,科学,全面地认识和测量卫生保健需要,分析其与卫生服务需求和提供的关系,是更好的满足整个人群的卫生保健需要,使需要,需求和提供三者相匹配的基本前提,才能确保实现充分利用有发的资源,更经济,有效地提供卫生服务,保障和促进人群健康的宗旨。     

中国农村贫困地区社会经济特征与卫生筹资

中国农村贫困地区经济发展缓慢,经济水平低,政府经济负担大,贫困与健康关系密切,文化落后,教育水平低,因病致贫,因病返贫形成恶性循环。建议贫困地区卫生筹资纳入政府议事日程,多渠道,多途径进行卫行筹资,从健康保障制度着手,全面推行合作医疗保健制度,解决农民就医和卫生服务的普及性。     

Self-reported change in health behaviour after a mass media-based health education campaign

A comprehensive short-term fund-raising campaign, was launched in 1987 by a health charity organization in cooperation with the only Norwegian TV-channel covering the whole country. The campaign which was extensively announced on TV and other media and which involved large proportions of the population, finished up with a six hour TV-show on the fund-raising day. Because a considerable amount of information on prevention of heart disease was presented in connection with the campaign, it is presently evaluated as a nationwide health education campaign. Twenty-two per cent of the population reported changes in one or more habits in connection with the campaign (one third of them took more exercise, while one quarter reduced/quit their smoking). Health behaviour change among family/friends, reported new knowledge of health and worry created by the campaign, were the factors most clearly associated with self-reported behaviour change. The paper discusses the magnitude of the effects of the campaign in relation to the study design, and the importance of social environment and fear arousal on health behaviour.     

Assessing Hypochondriasis: Findings on the Survey of Health Concerns

We describe a brief self-report measure for assessing hypochondriacal fears in adults. Called the Survey of Health Concerns (SHC), the measure was developed using DSM IV criteria for diagnosing hypochondriacal disorder as a guide. The measure was standardized on a sample of 188 college students. It was shown to have good internal and temporal reliability over a 2-week period. Moreover, scores on the SHC correlated significantly with worry proneness as measured by the Penn State Worry Questionnaire, and with the Hs scale of the MMPI-2, which together support the convergent validity of the measure. While men and women scored the same, participants who were being treated for a medical condition scored higher than those who were not being treated. Men who were under a doctor's care scored especially high, although this was based on a small sample of men and the effect could be spurious. A principal component factor analysis revealed two primary factors: one that described participants who felt poorly, made frequent trips to the doctor, and were fearful of illness and dying, and another that described participants who were particularly fearful of infectious diseases and took active steps to avoid becoming sick. Relatively little is known about hypochondriacal disorder. One reason for the dearth of knowledge in this area is that there has been no practical and reliable way to assess hypochondriacal fears, or more generally speaking, people's tendency to worry about their health. The SHC may help to fill this void. Results are admittedly preliminary and further study in medical settings is needed.     

Immunity and health after bereavement in relation to coping

Coping was examined as an intervening variable between the stressor of bereavement and its effects on subjective health and immunity in thirty-nine recently bereaved Norwegian women. Coping was defined as: "positive response outcome expectancies". Data were collected approximately one month after the death of the husband, and twelve months thereafter. Data collected were: expected coping success (self-scoring), subjective health (UHI), anxiety and depression (GWB), and immunoglobulins (IgA, IgM, IgG) with components (C3, C4). Statistics were: frequencies, paired t -test, ANOVA, and MANOVA. Permissions and confidentiality were in accordance with the Helsinki-declaration. Coping was found to be related strongly to health and to health changes. Few relations were found between immunity and health. Coping, health, and anxiety and depression formed a triangle of interrelations. It was concluded that coping defined as "positive response outcome expectancies" may be a predictor of the adaptational outcome after a crisis.     

The extra credit effect in interpersonal attraction

An experiment was conducted in which three levels of personal evaluation (positive, mixed, or negative) were crossed with two levels of dependence of the evaluator (high or low) and two levels of accuracy of the evaluation (high or low). Liking for the evaluator was expected to increase linearly with the favorableness of the evaluation, with two possible exceptions: When a positive evaluation from a dependent evaluator was inaccurate, and when a negative evaluation from a dependent evaluator was accurate. In the former case, the obvious inaccuracy of the positive evaluation in the face of the temptation to ingratiate was expected to elicit a decrement in liking (an “ingratiation effect”) by the person being evaluated. In the latter case, the honesty of the evaluator in the face of the temptation to ingratiate was expected to elicit an increment of linking (an “extra credit effect”) by the person being evaluated. Only the second of these two possibilities was supported.     

A Test of Contextual Theory: The Relationship Among Relational Ethics,Marital Satisfaction,Health Problems,and Depression

Few studies have examined the theoretical underpinning of contextual theory. Using structural equation modeling, the relationship among relational ethics (recognized as the most important aspect of contextual theory), marital satisfaction, depression, and illness was examined. Data came from a national sample of 632 mid-life, married individuals. Results supported Nagy’s contextual theory. The total score of the Relational Ethics Scale was a significant predictor of marital satisfaction, and marital satisfaction was significantly associated with depression and health problems. Vertical and horizontal subscales of relational ethics also were significant predictors of depression and health problems through the mediating variable of marital satisfaction.     

Stresses reported by UK trainee counselling psychologists

This study examined stressors and psychological distress in 109 UK counselling psychology trainees. The research focus was two-fold. What is the profile of stressors that counselling psychology trainees report about the components of training? What relationship is there between this profile, and other characteristics of trainees, including their level of current psychological distress? Data from a stress survey and from the General Health Questionnaire were examined. High stress scores were found on three aspects of the stress survey (‘academic’, ‘placements’, ‘personal and professional development’), but not–surprisingly–on the aspect, ‘lack of support systems’. Significant stress differences were reported for gender and age of participants, and highly significant positive relationships were found between General Health Questionnaire and stress scores. Overall, the results suggest actions to be taken. Further research is needed to clarify unavoidable and avoidable stressors in training, and the reduction of trainees’ experience of training stress to the necessary minimum needs to be adopted as an active target by programmes.     

Infant feeding and HIV in Sub-Saharan Africa: what lies beneath the dilemma?

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities.