Hjärtinfarkt är en av de vanligaste dödsorsakerna i Sverige idag och kvinnor har en högre mortalitet vid hjärtinfarkt. Kvinnor dröjer med att söka vård vid symtom på hjärtinfarkt, det finns ett flertal orsaker som fördröjer tiden från första symtom till kontakt med sjukvården. Orsakerna till den ökade fördröjningstiden för kvinnor kommer att belysas i denna litteraturbaserade studie.  Resultatet redovisas i två teman på orsaker om varför kvinnor dröjer med att söka vård vid symtom på hjärtinfarkt. Kvinnor ville inte vara till besvär för sina anhöriga eller arbetsgivare. De ville heller inte vara till besvär för hälso- och sjukvårdpersonal då de inte ville belasta sjukvården i onödan och de upplevde även en rädsla att inte bli tagna på allvar utav hälso- och sjukvårdpersonal. Kvinnorna hade också vilseledande föreställningar om hjärtinfarkt. Föreställningarna kommer från massmedia samt erfarenheter från män i sin omgivning som drabbats av hjärtinfarkt. Kvinnorna hade även svårigheter att härleda symtomen till hjärtinfarkt och de försökte hitta andra förklaringar till sina symtom eller förminskade dessa. På grund av dessa svårigheter försökte kvinnorna hantera symtomen själv genom självmedicinering.   Sjuksköterskan behöver en ökad kompetens om kvinnor och hjärtinfarkt, då hon har en viktig funktion att utbilda kvinnor om hjärtinfarkt och symtombild. Detta är för att kvinnan ska kunna ta ett snabbt beslut att söka vård för att därmed förbättra prognosen vid hjärtinfarkt. / Background: Time is crucial for the forecast of myocardial infarction. It’s crucial for the prognosis and can decrease complications. Complications can include both physical and psychological ailments and can affect women’s daily life. Aim: The aim of this study was to illustrate why women delay seeking care for symptoms of myocardial infarction.  Method: A literature-based study. Results: The reasons that women delayed seeking care of their symptoms were fear of being an inconvenience for either their relatives and/or health care professionals. They had also a misleading conception about myocardial infarction and had difficulties to connect their symptoms to myocardial infarction. Therefore the women try to attempt to perform self-care rather than consult medical professionals. They also prioritized obligations against employer and related.  Conclusion: Women want to be self-sufficient enough to take care of themselves and not be a burden to their family or medical professionals. They had difficulties prioritizing themselves and the women has to start put herself first. Through increased knowledge about symptoms for myocardial infarction the result may be that women can take better and more informed decisions on when it is imperative to seek immediate medical care. This may in turn result in better prognosis for the affected women.

The present study investigates the information gathering behaviour of the academic researchers at Sultan Qaboos University in the Sultanate of Oman. It endeavours to explore researchers' awareness and attitudes towards information sources and services. Research methods for this study were designed from the user-centred perspective with triangulation approach. Hence, data was collected by the use of semistructured interviews as the main instrument with journal study and observation as supplementary tools. The information was collected from the members of the research community in their capacity as users of information. The study investigates the information needs and information gathering habits of the research community and attempts to identify the problems experienced by researchers in accessing and using information. It also seeks to explore the national policy for planning and provision of information. Finally the study examines the performance of the various information services in the context of user needs and the status of the institution library information service provision. The research concludes that present information environment at Sultan Qaboos University is inadequate to meet the information needs of the research community. It was found that the major causes for the situation was the lack of clear information policies, inadequate funding, ineffective partnership between top management and academic researchers, lack of effective in house training and finally absence of a reliable information technology infrastructure.

Master of Public Health - MPH / Background: The Western Cape's Comprehensive Service Plan (CSP) is committed to "treating the right patient at the right level right, with the right skills and at the right cost" (Page 1, Tygerberg Hospital Annual Report, 2007). Occupational therapy (OT) Managers in the Metro District, Western Cape Province are in the process of aligning the OT services to the new CSP document. A major problem is the high default rate (non attendance) and irregular attendance (patient attends but skips sessions) amongst paediatric out-patients. In order to properly improve the OT paediatric services, it is vital for the OT managers to know the reasons for the poor utilisation of the OT services at the paediatric out-patient units. Purpose of study: The irregular attendance and high default rates (where patients stop attending the OT sessions completely) among children are a major problem at three OT out-patient units in Cape Town, Western Cape Province. The occupational therapists who work at these units are adamant that this impacts negatively on the child's progress. This study sought to explore the factors influencing the utilisation of the OT service in these three OT paediatric out-patient units in the hope of providing relevant information to the OT managers of these units in order to rethink the current service and make appropriate changes to improve adherence and treatment progress. Study design: This was an exploratory study using qualitative research methods. In-depth interviews were conducted with ten parents of children who have to attend the OT out-patient services. One group discussion was conducted with the occupational therapists that provide the services at the out-patient units. Sampling: Purposive sampling methods were employed to select four occupational therapists (at least one from each unit) and ten parents (at least three from each unit, with at least two who attended poorly and one that attended regularly). Analysis: Thematic analysis was used to interpret the data. The data was coded and categorised according to themes that emerged during data analysis. Results: The results of this study revealed that the factors that impact the utilisation of the OT service at the three OT units is complex. Factors that influenced the utilisation of the OT services in this study were related to the OT service such as staff attitude, relationship between the occupational therapist and the mothers as well as their child, communication between the mother and the occupational therapist, treatment progress, parent involvement in the OT programme and access to the OT service. Other factors such as the mothers' perception of the severity of the child's health condition, family support, work factors and family support were important factors related to the mother. The findings also revealed that environmental factors namely stigma, discrimination and travelling to the OT units impacted utilisation of the OT service. The participants made recommendations on how to improve the service. Conclusion: This study describes the complexity of what impacted the utilisation of the OT services and how closely interlinked these different factors are. It is evident from the findings of this study that a comprehensive, client centred approach is required to properly deal with the factors that negatively impact the utilisation of this service. Recommendations: A multi-faceted approach is required. Important issues to address are the shortage of occupational therapists across the levels of health care in the Western Cape Province; improving on the client centred approach in OT intervention programmes; advancing advocacy against stigma and discrimination against children with disabilities; and making public transport more accessible to children and their mothers.

This study focuses on African male refugees and asylum seekers in Pretoria/Tshwane, the capital city of South Africa. Beyond the motives for their displacements, refugees, carrying different kinds of disturbances into their ‘new home’, seek health and therapy, because the very condition of being refugees can be understood as a health-seeking condition. An ethnographic study was conducted to investigate the different means, therapies and cures used by refugees from other African countries in order to correct the fractions of their lives that have been disrupted on their journey to becoming refugees. The study found that these male refugees associated health with self-fulfilment or well-being and this couldn’t be achieved without removing the stumbling blocks that were in their ways. Being in a foreign country and having been through humiliation and other disturbances, the need to consult certain institutions became a necessity, thus challenging the ‘classic’ constructions of masculinity. Being far from home increased the level of vulnerability and the need thereof to seek help. Belief in a magico-religious system being part of African healing systems and part of the corollaries of globalisation, modernity and urbanism; explanations for various causes of misfortune and cures were found in consulting pastors, healers, diviners, astrologists. Some of those healers and religious leaders from other African countries, being refugees were also in search of well-being, thus triggering the creation of their new professions in the land of refuge. Copyright / Dissertation (Master of Arts)--University of Pretoria, 2012. / Anthropology and Archaeology / unrestricted

Les médecins, et en particulier les médecins généralistes, sont confrontésquotidiennement à la difficulté de ne pas tout savoir. En médecine générale, l’étendue duchamp d’activité impose aux professionnels une maîtrise de plus en plus aiguë del’information, qui doit s’appuyer sur le développement d’une littératie numérique, c’està-dire la capacité d’utiliser et de comprendre les outils et médias numériques. Lesobjectifs de ce travail étaient d’identifier les obstacles à la recherche d’information chezles médecins généralistes et de développer et d’évaluer des outils susceptibles desurmonter ces difficultés.Pour cela, nous avons réalisé une étude qualitative auprès d’internes de médecinegénérale et de médecins généralistes français. Elle a permis de mettre en évidence denombreux obstacles à la recherche d’informations en santé en ligne. Ces obstaclesconcernent les professionnels et les outils, certains sont également d’ordre institutionnel.Parmi ces obstacles figure la langue anglaise, qui semble constituer un repoussoir pourles médecins installés mais également pour les médecins en formation. D’après lesdonnées que nous avons recueillies, ce frein concerne aussi bien l’information en ellemêmeque son support.Plusieurs des outils développés par l’équipe du Département d’Informatique etd’Information Médicales du CHU de Rouen ont vocation à répondre à ces difficultés. Labase de données bibliographiques LiSSa permet l’accès à plusieurs centaines de milliersde références francophones en santé, issues de PubMed mais également de revuesfrancophones non indexées dans PubMed. Le constructeur de requêtes bibliographiquesmédicales permet à des utilisateurs non anglophones de construire des équations derecherche complexes dans leur langue maternelle, leur permettant de requêter dansPubMed, LiSSa ou CISMeF. / Physicians, and especially general practitioners, are not « all-knowing ». As they areconfronted with a large amount of clinical situations, information and knowledgemanagement are essential topics of interest. This management is mainly based on thedevelopment of numeric literacy, that is the ability to use and understand digital tools andmedia. The aims of this work were to identify the obstacles encountered by generalpractitioners when seeking health information online and to develop and assess tools tohelp them to overcome these barriers.We performed a qualitative study among general practice residents and generalpractitioners. This allowed us to highlight several obstacles encountered by them whenseeking medical information online. These obstacles include both tools and professionals’issues. Institutional obstacles were also identified. Of these barriers, the insufficientcommand of English was cited as an important issue by both residents and physicians.The Department of Medical Information and Informatics of the Rouen University Hospitalhas developed several tools in order to facilitate access to knowledge for healthprofessionals. LiSSa is a bibliographic database containing only articles written in French.It allows health professionals and researchers, whose native language is not English, toaccess to hundreds of thousands of references, from PubMed and from journals notindexed in PubMed. A multi-lingual query builder to facilitate information retrieval wasdesigned. It appears to be an effective tool to improve the quality of PubMed queries inparticular for users whose first native language is not English.

Magister Scientiae (Occupational Therapy) - MSc(OT) / School dropout particularly amongst youth living in impoverished areas is a major concern in South Africa because of limited opportunities and resources. Therefore, these youth may experience leisure boredom, engage in sensation seeking and other risky behaviours, such as substance use, which influences their health and wellbeing. However, little research has explored youth who have dropped out of school with a specific focus on their free time experience and use of substances. Aim: The aim of the study was to explore and describe free time experience and substance use amongst youth who have dropped out of school in Cape Town. Methods: A sequential explanatory mixed methods study with two phases including quantitative (Phase one) and qualitative (Phase two) was conducted. In Phase one, data from an existing dataset was analysed. The data were from 970 youth who had dropped out of school in Cape Town who had completed the HealthWise Risk Behaviour Survey in 2016. Descriptive statistics regarding the use of free time and the prevalence of substance use were computed using the Statistical Package for the Social Sciences. In Phase two, thirty-two participants were selected using convenience sampling who took part in one of four focus group discussions to explore in-depth the results computed in Phase one of the study. Steps were taken to enhance the validity, reliability and trustworthiness of the data.

Malaria är ett globalt problem, som framförallt existerar i de tropiska delarna av världen. I Uganda uppskattas 25-40% av patienter som uppsöker statlig vård vara patienter som har relaterade malaria symtom. Eftersom Batwa är en minoritetsgrupp som skiljer sig från övriga Ugandier i sin historiska livsstil, undersöker denna studie hur denna grupp söker vård. Studien är kvalitativ och har använt sig av en etnografisk metod, därav tio intervjuer och en fokusgrupp diskussion för att samla data. Det teoretiska ramverket har varit medicinsk antropologiskt, där en hälsouppsökande modell har använts. Resultatet visar på en mängd olika hälsoalternativ för Batwa att söka vård inom. Dock skiljer sig Batwas hälsouppsökande beteenden från andra gruppers beteenden, enligt tidigare studier, och från det teoretiska ramverkets modell, som använts i uppsatsen. Batwa föredrar offentlig vård i högre grad, eftersom det är ett billigare och ett mer lättillgängligt alternativ att bli frisk på, i jämförelse med många andra alternativ. / Malaria is a global problem that exists mostly in the tropical region of the world. In Uganda approximately 25-40% of the patients who are seeking governmental healthcare are patients with malaria related symptoms. Because Batwa is a minority group who differ from other Ugandans in their historical lifestyle, the present study investigates how this group are seeking healthcare. The study is qualitative and has used an ethnographic method, whereby ten interviews and one focus-group discussion to collect data. The theoretical framework has been medical anthropology, where a healthcare seeking model has been used. The result reveals a varied spectrum of healthcare option for Batwa too seek treatment within. However, Batwa healthcare seeking behaviour differs from other groups of healthcare seeking behaviour, according to earlier studies, and from the model used in the theoretical framework in the present study. Batwa prefer governmental healthcare in a greater extent, because it is cheaper and a more accessible alternative to get treated, compared to many of the other alternatives.

Female genital schistosomiasis (FGS) is a chronic manifestation of schistosomiasis, a waterborne parasitic infection, and is estimated to impact 56 million women predominantly in Sub-Saharan Africa. Currently, there is scarce literature on FGS and related health-seeking behaviour (HSB) among at-risk women. The objective of this mixed-method study is to understand the socio-cultural determinants of HSB and the health information trust networks for women at-risk of FGS in Ghana. A cross-sectional survey and twelve focus group discussions (FGDs) were conducted in the North Tongu and Weija Districts of Ghana. A total of 863 cross-sectional surveys and 12 FGDs were administered in both districts. There was an overall lack of awareness of FGS among adult women (38.9%). Only 48.8% of women reported HSB from the 86 women who choose to talk about their FGS-related symptoms. HSB was significantly associated with monthly steady income (p-value: 0.036) and level of education (p-value: 0.15,0.27), when controlling for age group and source of trusted health information. Some of the determining themes for HSB included: environmental and systemic context, shared norms, and apprehensions. Active and passive health information-seeking behaviour also emerged through the FGDs. Taking a mixed-method approach allowed for the appraisal of both methodologies and provided validity to the results. The lack of awareness of FGS indicates the need for tailored health information campaigns in endemic communities. More research is required on the FGS diagnostic and treatment capabilities of health facilities to understand their impact on HSB of women. This investigation finds that social, environmental, and cultural determinants are involved in the HSB of women at-risk for FGS, in North Tongu and Weija.

Background: The Syrian refugee crisis is one of the most significant humanitarian crises of our time and has resulted in over 6.5 million displaced individuals worldwide. Syrian refugees are a vulnerable population and are at considerably higher risk for mental health disorders including depression, anxiety, and post-traumatic stress disorder. However, despite the high prevalence, there is insufficient utilization of mental health services among Syrian refugees resettled in high-income countries. To help address this gap this study aims to investigate mental health conceptualization, coping, and help-seeking among Syrian refugee parents resettled in Canada to build a comprehensive understanding of the factors influencing perception and the decisions to seek help, thus adding to the knowledge base for refugee mental health and generating insight to help inform policy and program decisions for Syrian refugees resettled in Canada. Methods: Data was collected using semi-structured interviews with Syrian refugee parents (N=31) who have been permanently resettled in Canada. Interviews were conducted in Arabic and transcribed verbatim and were subsequently translated into English. Thematic analysis was used to analyze the data. Results Significant interlinkages were observed between the factors that influence mental health conceptualization, coping, and help-seeking. Our findings suggest that many refugees perceive mental health concerns as part of daily life and do not believe it requires professional intervention. This along with personal, cultural, and religious context have strong implications for help-seeking behaviour. Moreover, the availability of culturally sensitive services has the potential to increase service utilization. Knowledge of how individuals conceptualize mental health and cope can be leveraged to design more impactful mental health services for Syrian refugees. Conclusion: The factors influencing mental health conceptualization, coping, and help-seeking are deeply interconnected and must be considered holistically to improve policies and programming to increase the uptake of mental health services. / Thesis / Master of Health Sciences (MSc)

<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>