Determinants of health care utilization by immigrants in Portugal

<p>Abstract</p> <p>Background</p> <p>The increasing diversity of population in European Countries poses new challenges to national health systems. There is a lack of data on accessibility and use of health care services by migrants, appropriateness of the care provided, client satisfaction and problems experienced when confronting the health care system. This limits knowledge about the multiple determinants of the utilization of health services. The aim of this study was to describe the access of migrants to health care and its determinants in Portugal.</p> <p>Methods</p> <p>The study sample included 1513 immigrants (53% men), interviewed at the National Immigrant Support Centre, in Lisbon. Data were collected using questionnaires. The magnitude of associations between use of National Health Service and socio-demographic variables was estimated by means of odds ratios (OR) at 95% confidence intervals, calculated using logistic regression.</p> <p>Results</p> <p>Among participants, 3.6% stated not knowing where to go if facing a health problem. Approximately 20% of the respondents reported that they had never used the National Health Service, men more than women. Among National Health Service users, 35.6% attended Health Centres, 12% used Hospital services, and 54.4% used both. Among the participants that ever used the health services, 22.4% reported to be unsatisfied or very unsatisfied. After adjusting for all variables, utilization of health services, among immigrant men, remained significantly associated with length of stay, legal status, and country of origin. Among immigrant women, the use of health services was significantly associated with length of stay and country of origin.</p> <p>Conclusion</p> <p>There is a clear need to better understand how to ensure access to health care services and to deliver appropriate care to immigrants, and that special consideration must be given to recent and undocumented migrants. To increase health services use, and the uptake of prevention programs, barriers must be identified and approaches to remove them developed, through coherent and comprehensive strategies.</p

Illness causal beliefs in Turkish immigrants

<p>Abstract</p> <p>Background</p> <p>People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia.</p> <p>Methods</p> <p>Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness.</p> <p>Results</p> <p>Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness.</p> <p>Conclusion</p> <p>Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.</p

Resolution of psychiatric symptoms secondary to herpes simplex encephalitis

No abstract available

Antisickling properties of divanilloylquinic acids isolated from Fagara zanthoxyloides Lam. (Rutaceae)

Fagara zanthoxyloides Lam. (syn. Zanthoxylum zanthoxyloides) (Rutaceae) is the most cited Fagara species for the treatment and the prevention of sickle cell disease crisis. Sickle cell anemia (SCA) is a public health problem in many countries particularly in Africa. The present study was designed to evaluate the antisickling properties of three isomeric divanilloylquinic acids (3,4-O-divanilloylquinic acid or burkinabin A; 3,5-O-divanilloylquinic acid or burkinabin B and 4,5-O-divanilloylquinic acid or burkinabin C) identified previously by LC/MS/NMR analysis in the root bark of F. zanthoxyloides [Ouattara et al. 2004. LC/MS/NMR analysis of isomeric divanilloylquinic acids from the root bark of Fagara zanthoxyloides Lam. Phytochemistry 65, 1145-1151]. The three isomers showed interesting antisickling properties which increased from burkinabins A to C. © 2008 Elsevier GmbH. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Avaliação dos cuidados de saúde: percepções de mulheres imigrantes em Portugal Health care assessment: the perceptions of female immigrants in Portugal

OBJETIVOS: descrever práticas relacionadas com a procura de cuidados de saúde e percepções relativamente a aspectos da utilização dos serviços de saúde por parte de uma população de mulheres imigrantes a residir em Portugal. MÉTODOS: em 2009 foi realizado um estudo transversal na área metropolitana de Lisboa onde foi aplicado um inquérito por questionário a uma amostra de 703 mulheres imigrantes. O questionário incluiu itens para caracterização sóciodemográfica e sobre práticas relacionadas com a procura de cuidados de saúde e percepções das participantes quanto à utilização dos serviços. Realizou-se uma análise descritiva das variáveis em estudo. RESULTADOS: a grande maioria das participantes (82.4%) reporta já ter utilizado o Serviço Nacional de Saúde (SNS), mais frequentemente as africanas (94,5%) e do Leste Europeu (87,2%) do que as brasileiras (66.8%). Cerca de 60% das inquiridas revela estar satisfeita ou muito satisfeita com os serviços, mais frequentemente as africanas (77%) do que as brasileiras (49,7%) e do Leste Europeu (43,4%). Os grupos de participantes apontam diferentes obstáculos para a utilização dos serviços de saúde, entre os quais aspectos relacionados com a condição de ser imigrante, a interação com os profissionais de saúde e os serviços. CONCLUSÕES: as diferenças nas percepções dos grupos de imigrantes sobre os serviços e profissionais refletem a importância de desenvolver práticas avaliativas que identifiquem necessidades de intervenção. Tal conhecimento pode contribuir para melhor adequar a prestação de cuidados de saúde às especificidades dos grupos de imigrantes.<br>OBJECTIVES: to describe the health care seeking behavior and perceptions relating to the use of health services of women immigrants residing in Portugal. METHODS: in 2009 a cross-sectional study was carried out in the metropolitan area of Lisbon, in which a questionnaire was applied to a sample of 703 women immigrants. The questionnaire included items relating to social and demographic characteristics and the health care seeking behavior and perceptions of the participants regarding the use of services. A descriptive analysis of the variables under study was carried out. RESULTS: most participants (82.4%) reported that they had already used the National Health Service (SNS), although this response was more frequent among Africans (94.5%) and East Europeans (87.2%) than among Brazilians (66.8%). Around 60% of respondents reported that they were satisfied or highly satisfied with the service, with the Africans responding in this manner more frequently (77%) than the Brazilians (49.7%) and East Europeans (43.4%). The groups of participants point to various obstacles to the use of health services, including issues related their status as immigrants, interaction with health professionals and the services provided. CONCLUSIONS: differences in the perceptions of immigrant groups regarding health services and professionals reflect the importance of developing evaluative practices that identify where intervention is needed. Knowing this would make it possible to better adapt the health care provided to specific immigrant groups