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      The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study

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          Abstract

          Background

          Canadians’ health care-seeking behaviour for physical and mental health issues was examined using the international Quality and Cost of Primary Care (QUALICOPC) survey that was conducted in 2013 in Canada.

          Method

          This study used the cross-sectional Patient Experiences Survey collected from 7260 patients in 759 practices across 10 Canadian provinces as part of the QUALICOPC study. A Responsive Care Scale (RCS) was constructed to reflect the degree of health care-seeking behaviour across 11 health conditions. Using several patient characteristics as independent variables, four multiple regression analyses were conducted.

          Results

          Patients’ self-reports indicated that there were gender differences in health care-seeking behaviour, with women reporting they visited their primary care provider to a greater extent than did men for both physical and mental health concerns. Overall, patients were less likely to seek care for mental health concerns in comparison to physical health concerns. For both women and men, the results of the regressions indicated that age, illness prevention, trust in physicians and chronic conditions were important factors when explaining health care-seeking behaviours for mental health concerns.

          Conclusion

          This study confirms the gender differences in health care-seeking behaviour advances previous research by exploring in detail the variables predicting differences in health care-seeking behaviour for men and women. The variables were better predictors of health care-seeking behaviour in response to mental health concerns than physical health concerns, likely reflecting greater variation among those seeking mental health care. This study has implications for those working to improve barriers to health care access by identifying those more likely to engage in health care-seeking behaviours and the variables predicting health care-seeking. Consequently, those who are not accessing primary care can be targeted and policies can be developed and put in place to promote their health care-seeking behavior.

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          Most cited references 20

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          Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes.

          The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults' willingness to seek specialty mental health services.
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            Consultation length in general practice: cross sectional study in six European countries.

            To compare determinants of consultation length discussed in the literature with those found in consultations with general practitioners from different European countries; to explore the determinants of consultation length, particularly the effect of doctors' and patients' perceptions of psychosocial aspects. Analysis of videotaped consultations of general practitioners from the Eurocommunication study and of questionnaires completed by doctors and by patients. General practices in six European countries. 190 general practitioners and 3674 patients. In a multilevel analysis with three levels (country, general practitioner, and patient), country and doctor variables contributed a similar amount to the total variance in consultation length (23% and 22%, respectively) and patient variables accounted for 55% of the variance. The variables used in the multilevel analysis explained 25% of the total variation. The country in which the doctor practised, combined with the doctors' variables, was as important for the variance in consultation length as the variation between patients. Consultations in which psychosocial problems were considered important by the doctor and the patient lasted longer than consultations about biomedical problems only. The doctor's perception had more influence in this situation than the patient's. Consultation length is influenced by the patients' sex (women got longer consultations), whether the practice was urban or rural, the number of new problems discussed in the consultation (the more problems the longer the consultation), and the patient's age (the older the patient the longer the consultation). As a doctor's workload increased, the length of consultations decreased. The general practitioner's sex or age and patient's level of education were not related to the length of consultation. Consultation length is determined by variables related to the doctor and the doctor's country as well as by those related to patients. Women consulting in an urban practice with problems perceived as psychosocial have longer consultations than other patients.
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              Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association.

              Patients with the greatest health care needs may have the least ability to read and comprehend information needed to function successfully as patients. To examine the scope and consequences of poor health literacy in the United States, characterize its implications for patients and physicians, and identify policy and research issues. The 12 members of the Ad Hoc Committee on Health Literacy, American Medical Association Council on Scientific Affairs, were selected by a key informant process as experts in the field of health literacy from a variety of backgrounds in clinical medicine, medical and health services research, medical education, psychology, adult literacy, nursing, and health education. Literature review using the MEDLINE database for January 1966 through October 1, 1996, searching Medical Subject Heading (MeSH) reading combined with text words health or literacy in the title, abstract, or MeSH. A subsequent search using reading as a search term identified articles published between 1993 and August 1998. Authors of relevant published abstracts were asked to provide manuscripts. Experts in health services research, health education, and medical law identified proprietary and other unpublished references. Consensus among committee members was reached through review of 216 published articles and additional unpublished manuscripts and telephone and Internet conferencing. All committee members approved the final report. Patients with inadequate health literacy have a complex array of communications difficulties, which may interact to influence health outcome. These patients report worse health status and have less understanding about their medical conditions and treatment. Preliminary studies indicate inadequate health literacy may increase the risk of hospitalization. Professional and public awareness of the health literacy issue must be increased, beginning with education of medical students and physicians and improved patient-physician communication skills. Future research should focus on optimal methods of screening patients to identify those with poor health literacy, effective health education techniques, outcomes and costs associated with poor health literacy, and the causal pathway of how poor health literacy influences health.
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                Author and article information

                Contributors
                thompsae@uwosh.edu
                yanisimowicz@gmail.com
                baukje.miedema@horizonnb.ca
                whogg@uottawa.ca
                walter.wodchis@utoronto.ca
                kris.aubrey@med.mun.ca
                Journal
                BMC Fam Pract
                BMC Fam Pract
                BMC Family Practice
                BioMed Central (London )
                1471-2296
                31 March 2016
                31 March 2016
                2016
                : 17
                Affiliations
                [ ]Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, PO Box 9000, Fredericton, NB E3B 5N5 Canada
                [ ]University of Ottawa, Ottawa, ON Canada
                [ ]University of Toronto, Toronto, ON Canada
                [ ]Memorial University, St. John’s, NL Canada
                Article
                440
                10.1186/s12875-016-0440-0
                4815064
                27036116
                © Thompson et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: Canadian Institutes for Health Information
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/100008874, Canadian Foundation for Healthcare Improvement ;
                Funded by: Nova Scotia Health Services Research Foundation
                Funded by: la Commissaire à la santé et au bien-être et la Fédération des médecins omnipraticiens du Québec
                Funded by: Department of Health New Brunswick
                Funded by: Health System Performance Research Network funded by the Ontario Ministry of Health and Long Term Care
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Medicine

                health care-seeking behaviour, primary care, gender

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