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Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains v, 113 p. : ill. Includes abstract. Includes bibliographical references (p. 96-113).

A Research Submitted to the Faculty of Health Sciences (School of Public Health), University of the Witwatersrand, in Partial Fulfilment of the Requirements for the Degree of Masters in Public Health in the field of Social Behaviour Change and Communication 27 May 2014 / Introduction: HIV/AIDS services are now given freely at public health facility level. They have been decentralized to the formal primary health facilities in the rural areas. Despite the efforts by the South African government, the utilization of those services remains a challenge. There are gender disparities in utilisation of HIV/AIDS services as females utilize the services in greater numbers compared to their male counterparts. The newly diagnosed seropositive men tend to disappear soon after HIV testing, only to appear in a formal health system when their immune system is seriously suppressed and at a more advanced WHO stage of disease. Therefore, the overall aim of this study was to explore the underlying perceptions and beliefs that influence utilization of HIV/AIDS services by newly diagnosed HIV positive men in Mbashe Sub-District of the Eastern Cape between January 2010 and March 2011 Methods: The study was conducted in the rural Mbashe Sub-District of the Eastern Cape Province and utilized a qualitative methodology. This qualitative approach relied on semi-structured in-depth interviews with newly diagnosed HIV positive men of 18-49 years of age who were either accessing or not accessing the HIV/AIDS services during January 2010 and March 2011.The participants were recruited through purposive sampling and 18 interviews were conducted in 6 different facilities at three different service levels. Interviews were audio-recorded and transcripts were subjected to thematic content analysis based on the Health Belief Model. Results: The results show that both groups of men reacted negatively to HIV positive status. The experiences during HIV Counselling and Testing were not linked to whether men could access services. The barriers to utilizing the available HIV/AIDS services included fear of stigma and discrimination, need for an alternative quick cure which delayed utilization of the services, the clinic as gendered space, compromised Provider-Initiated Counselling and Testing (PICT) model implementation, shortage of food, physical fitness and alcoholism. The facilitators for access included the need for survival, disclosure and social support, and cues to action like witnessing a relative dying due to HIV/AIDS related illness. However, the HBM model could not squarely explain the trends in accessing HIV service since few constructs were found to be relevant and also some issues that are outside the HBM model emerged. Conclusions: The study demonstrates that newly diagnosed men‟s utilization of the subsequent free HIV/AIDS services at the primary health care level is influenced by many factors . There are those factors that trigger men to utilize the services and those that deter them from accessing necessary HIV/AIDS services. The factors that influence their access to services are mainly within the multilevel framework which ranges from individual, family, community and societal factors. Therefore, the targeted interventions to address the issue should focus on addressing stigma and discrimination, policy change on training, recruitment and deployment of male nurses, integration of traditional/spiritual interventions within the mainstream of health services, correct implementation of the PICT model and encouraging couple counselling and testing. The Health Belief Model constructs, especially perceived severity, were not strongly linked to whether men accessed services or not.

Thesis (M.S.)--University of Toledo, 2009. / Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science Degree in Pharmaceutical Sciences, Administrative Pharmacy Option." "A thesis entitled"--at head of title. Bibliography: leaves 71-84.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009. / Title from title screen (site viewed March 2, 2010). PDF text: x, 96 p. : col. ill. ; 471 K. UMI publication number: AAT 3386834. Includes bibliographical references. Also available in microfilm and microfiche formats.

Optimal effect of medical treatment requires patients' adherence to those treatments, which plays a even greater role than the medical decision made by physicians. With the epidemiological dynamic evolving, chronic disease becomes the major burden of healthcare, such as AIDS, hypertension, COPD, tuberculosis, asthma, epilepsy, schizophrenia, depression and diabetes, which make the adherence especially medication adherence a sightworthy issue because the risk of poor adherence with the complexity and duration of treatment with both of them are inherent to chronic diseases. Among patients with hypertension, medication nonadherence contributes to poorly controlled blood pressure as an significant yet unrecognized role. With the mediator of negative outcomes of further development of vascular disorders, including stroke, heart failure, renal insufficiency and coronary diseases, medication nonadherence to antihypertensives become the root of all devil in terms of healthcare. In terms of healthcare utilization, it costs approximately 396 to 792 million dollars per year and creates a significant burden. Effect factors for medication nonadherence among hypertension patients include knowledge about hypertension, beliefs about hypertension, perceived beliefs about medication, inadequate self-management behaviors, physician-patient relationship, social support and healthcare policy. The achievements of current single level interventions are not satisfactory, therefore multiple level interventions are calling for attention.Everyone in the healthcare system are responsible to alter the situation. A comprehensive healthcare system that consummates all the effect factors is the effective and efficient solution. / published_or_final_version / Public Health / Master / Master of Public Health

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The main purpose of this research study was to identify variables within the physician-patient relationship that may have a relationship to patients' intentions to adhere to medical recommendations. A literature review regarding the physician-patient relationship identifies two important variables: trust and empathy. This study investigated the impact of trust and empathy on patients' intentions to adhere to medical recommendations. Ajzen's Theory of Planned Behavior (Ajzen, 1988) (Figure 1) was used as a theoretical cognitive framework to help conceptualize the proposed study. Trust and perceived empathy were proposed as variables in the physician-patient relationship that influence a patient's subjective norm, attitude toward the behavior, and perceived behavioral control sufficiently to affect the patient's intentions to adhere to medical recommendations (Figure 2).The participants in this investigation included 128 adult Family Practice Clinic patients, who completed a set of questionnaires following an appointment with their physician. Participants completed the measures of the Perceived Empathy Scale (Plank, Minton, & Reid, 1996), the Trust in Physicians Scale (Anderson & Dedrick, 1990), and a short author generated measure of intentions to follow medical recommendations. The survey included four demographic variables: sex, age, marital status, and number ofphysicians' appointments.A hierarchical regression was performed which indicated that trust in the physician was not a statistically significant predictor of intentions to adhere to medical recommendations. However, patient perceived empathy from the physician was a statistically significant predictor of patients' intentions to adhere to medical recommendations. The only statistically significant demographic predictor of intentions to adhere to medical recommendations was marital status, indicating that participants who were married were more likely to express intentions to follow medical recommendations that those who were not. / Department of Counseling Psychology and Guidance Services

Calls for innovations and research echo in the latest reviews and meta-analyses of methods to enhance compliance (Haynes, McDonald, Garg, & Montague, 2003; Pekkala & Merinder, 2002; Peterson, Takiya, & Finley, 2003). In spite of effective therapy emerging daily from medical research, non-compliance appears at disappointing rates. Over the past 25 years, the gap is widening between what we could achieve with available and emerging health care and what we are currently achieving. This lack of compliance with proven therapy thwarts health outcomes and adds to the growing health care costs. In Canada, direct and indirect costs resulting from non-compliance with therapies amount to 7 to 9 billion dollars per year (Coambes, Jensen, Hao Her, Ferguson, Jarry, Wong, & Abrahamsohn, 1995; Coambs, 1997; Tamblyn & Perreault., 1997). / Many stakeholders play a role in the complex compliance equation. The physician plays a key role. Supporting physician maintenance of competence are continuing health educators. Together, the physicians and educators seek to employ the latest evidence in their practices to enhance compliance. Explicating the thinking that guides their medical and educational practices helps researchers and educators to understand problems in current approaches to compliance. / It is argued that prior knowledge is the basis for learning (Limon & Mason, 2002). Understanding current knowledge and behavior of a learner establishes the baseline to build effective educational activities that will impact targeted outcomes. Further, education designed by using learner's prior knowledge is the scaffold for future learning (Alexander, 1996). / This survey research examines the thinking and behavior of a randomized sample of Canadian physicians and networking sample of educators. Quantitative and qualitative analysis of participant thinking and interventions reveal different perspectives and mental models that guide their clinical and educational decisions. The findings reveal important differences with current clinical recommendations. The study identifies important variables that explain the differences and lack of progress in this area. / Directions for future education and research are forwarded. The recommendations, based in theories of change and cognition, offer important insights and opportunities to make advances toward enhancing current rates of compliance.

Thesis (MNurs)--University of South Australia, [2000]