Epidemiological investigation of factors affecting SeΙf-rated health and self-medication

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Date

2024-06-24

Authors

Βελισσάρη, Ιωάννα

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Abstract

OBJECTIVE In this thesis, the knowledge, attitudes and practices of self-rated health, self-medication and self-medication with antibiotics were investigated and evaluated, in two distinct population teams young parents and students. A new research tool was developed and validated for the analysis of the factors determining health self-assessment and self-medication which were investigated as well as their correlation with various socio-demographic and other characteristics was made. The degree of correlation of the self-esteem of health with the morbidity of the population, as well as the taking of medicines and antibiotics without medical instruction, and which effects, this practice has on our health and Public Health in general, was sought and highlighted. METHODOLOGY To conduct the research, it was necessary to develop and validate a questionnaire as a research tool. The final structure and format of the questionnaire consisted of the following sections: Demographic data, concepts on self-assessment of health, self-medication, and taking antibiotics without medical instruction. The survey tool was distributed to the study sample in two formats (printed and electronic format). The two distinct research samples consisted of 667 students and 551 young parents of children in primary schools. After the sample was collected, the statistical analysis of the data was done with the use of the IBM SPSS 24 programme. RESULTS The final version of the questionnaire consisted of 6 domains and 85 sectional questions and was validated. The Item-Content Validity Index (I-CVI) ranged between 0.50 and 1.00. The CVR was generated for each item. Twenty-six items had a CVR of 1.00, eight a score of 0.9, four a score of 0.8, four a score of 0.7, and two a score of 0.5. The average CVR value was 0.9. For all items, modified Kappa (k*) values were excellent (> 0.8), revealing that the agreement between experts was not due to chance. The face validity of the questionnaire by reviewing the clarity and the completeness of the questions to measure the target outcome. The Intraclass Correlation Coefficient (ICC) assessment showed that the reliability was good in average measures (ICC=0.779). Cronbach’s coefficient alpha was used to check the overall reliability of the questionnaire using the data collected from the 135 adult individuals. The total sample responded to both questionnaires (paper and electronic format) were 667 students and 551 young parents of children in primary schools covering a variable and different population sample. In our data with students, 30% females and 23% males characterize their life as moderate or bad. 29% of females and 27% of males visited a doctor and the rest either followed a phone medical order or asked their family. They do not perform preventive exams (27% in females and 46% in males) due variable reasons such as financial, lack of time, do not feel them necessary. In our study, the prevalence of SM (always, often, or sometimes) without a medical prescription was 52% for males and 49.2% for females with similar prevalence in all three schools as all belong to health sector. About 44.9% of students considered SM as good or accepted practice; 74.3% were careful when self-medicating and reading the package leaflet of self-medicated drugs. About 28.4% had received antibiotics and the reason was convenience (25%) or distrust of medical advice. The students in our study believe that SM is a good or accepted practice (44,9% females and 42,63% for males). In our study, SM was significantly associated with age, gender, and students’ academic year as females, medical students, and last year students tended to self-medicate more than their peers with significant differences between them.SM was reported by 79.9% of students. The most used drugs were analgesics. The prevalence reported in our study is quite significant. It was surprising to find that there was no significant difference in the prevalence rates of self-medication amongst different health students. In our data with parents, 23% and 53% characterize their life as bad or moderate, respectively, whereas only 21% always and 23% often visited a doctor and the rest either followed telephone medical orders or asked their family. They do not perform preventive exams due to main reasons such as financial, lack of time, or “do not feel them necessary”. In our study, the prevalence of SM (always, often, or sometimes) without a medical prescription was 15.3 with similar prevalence in all primary schools. Receiving advice mainly from the family/friends (44.1% for females and 42.9 for males) about SM and the reuse of old prescriptions contributes to the risk posed by home pharmacies. Further explanations for SM cited by parents included “there is no need to see a doctor for my child because of a simple disease” and “quick relief.” About 29% of parents considered SM as good or accepted practice; 74.3% were careful when self-medicating and reading the package leaflet of self-medicated drugs. About 28.4% had received antibiotics and the reason was convenience (25%) or distrust of medical advice. Different genders show similar percentages in self-medication. The students in our study believe that SM is a good or accepted practice (44.9% females and 42.63% for males). The prevalence reported in our study is quite significant. It is also worthy to note here that parents belong to general population of society and if the prevalence of self-medication is high, then the prevalence in the rest of the community maybe a significant health issue. CONCLUSIONS In conclusion and according to the research results, self-rated health is a very important indicator for both morbidity and mortality of the population, especially when this population is the student population of the country. Further research and investigation of self-rated health is certainly needed. On the other hand, self-medication and especially self-medication with antibiotics are two very important and burning issues for Public Health. The incorrect and reckless use of medicines can create resistant bacteria endangering Public Health. Overuse of antimicrobial drugs is a global problem. A holistic approach must therefore be adopted to prevent this problem which may include (i) awareness and education regarding the consequences of self-medication (ii) strategies to prevent the supply of over-the-counter drugs (iii) strict rules on pharmaceutical advertising and (iv) strategies to provide healthcare to all by eliminating health inequalities.

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Keywords

Self-assessed health, Self-efficacy, Self-medication, Self-rated health, Prevention, Questionnaire, Validity, Quality of life, Risk factors, Knowledge, Perception, Attitude, Antibiotics, Drugs, Risk factor analysis, Epidemiology, Bioethics

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