International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 13 (2), pp. 001-012, February, 2024. © International Scholars Journals

Full Length Research Paper

Perceptions of key figures on the capacity of the Romanian healthcare system to address population needs

Constanța MIHĂESCU-PINȚIA^1,2, Rodica PAMFILIE², Aurelia ȘTEFĂNESCU³*, Narcis COPCA⁴ and Marian Vladimir CONSTANTINESCU⁵

¹National School of Public Health, Management and Professional Development, 31 Vaselor Street, Sector 2, 021254 Bucharest, Romania.

²Faculty of Commerce, Bucharest Academy of Economic Studies, Romania.

³Faculty of Accounting and Management Information Systems, Bucharest Academy of Economic Studies, Romania.

⁴"St.Maria" Clinical Hospital, Bucharest, Romania.

⁵Faculty of Dentistry, "Carol Davila" Medical University, Romania.

Accepted 4 November, 2023

Abstract

Difficulties of Romanian healthcare system generated by “Semasko inheritance”, a decision making process not properly substantiated, inadequate administration of resources, continuous change of regulations, health reform discontinuity, poor endowment of many health facilities and migration of medical personnel, within the low economic development in comparison with EU and country potential, have a significant impact on health services utilization and consequently, on population health status. Although social health insurance fund increased 10 times during 1999 to 2008, its positive effects on health system and health status can hardly be noticed. Within this context, our research questionnaire-based, aims to investigate the opinion of key persons from all relevant actors, regarding Romanian system capacity to respond to healthcare needs of population. Although population perception on healthcare has been studied many times in Romania, there was a lack of research among key professionals in order to produce skilful opinions and competent recommendations. This study started with a synthesis of main approaches and findings published on this subject. Most respondents reasoned the limited responsiveness of Romanian healthcare system to specific needs by: poor achievement of system functions, relative adequacy of reforms to necessities, under-financing, excessive politicization, poor management, inefficient use of resources, improper health infrastructure, medical personnel dissatisfaction, etc. Respondents identified areas for priority action and proposed alternative solutions to currents problems, shaping a new managerial model for the health system. We think that grading the Romanian healthcare system with a six in average by key respondents, confirms the discrepancy in structure and quality between the health services demand and supply, representing a useful tool for redefinition of reforms according to real needs and expectations.

Key words: Healthcare system, responsiveness, healthcare needs, health services supply, Romania, key persons.

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (1), pp. 001-013, January, 2023. © International Scholars Journals

Full Length Research Paper 

Patterns of behavior and adherence to inhalation therapy in patients with COPD

Claudio Micheletto1, Cristiana Bertolucci2, Lucio Corsaro3, Alessio Piraino4 and Gianluca Vaccaro5

¹Respiratory Unit, University Hospital Verona, Piazzale Aristide Stefani, 1 – 37126, Verona - Italy

²Chiesi Italia S.p.A. Via Giacomo Chiesi 1 – 43122, Parma - Italy

³Founder & Advisor at Bhave, Via Giambattista Vico 1 – 00196, Rome – Italy

⁴Medical Affairs, Chiesi Italia S.p.A., Via Giacomo Chiesi 1 – 43122, Parma – Italy

⁵PhD, Methodological Advisor at Bhave, Via Giambattista Vico 1 – 00196, Rome - Italy; Sociologist UO Education and Health Promotion, Asp Catania, Via Santa Maria la Grande 5 – 95124, Catania, Italy.

Accepted 19 January, 2023  

Abstract

Background. COPD is a leading cause of chronic morbidity and mortality worldwide. For the treatment success it is also necessary to ensure long-term adherence to inhaled drug therapy, whose levels are generally around 50% due to a series of factors involving medication, characteristics of the device system, and patient’s and healthcare professionals’ behaviors. Today important gaps persist in the knowledge of behaviors, beliefs, preferences and self-perceived health status in patients with COPD, as well as in the social, economic or health contextual factors and their possible relationships with adherence to therapy as potential ‘adherence determinants’. Objective The present research aims to understand patterns of behaviour and type of routines related to the use of different kinds of device (spray or powder) and their possible relationships with the adherence to inhalation therapy in patients with COPD. Methods CAWI-CATI-FtoF sociological survey with structured questionnaire with standardized scales of measurement of adherence to a specific therapy for COPD, symptoms management and self-perceived health status. Inclusion criteria: patients with medical diagnosis of COPD and currently under inhalation treatment. Percentage shares of prevalent users of MDI, DPI over the years and both such as to guarantee the sub-analysis of clusters. Results COPD has a significant impact on life for most of the interviewees, in particular for 46% of them it has a high impact and for 15% a very high impact on their life and daily habits. A clear majority of interviewees reported partial (66%) or major (24%) limitations related to their physical health due to their disease, while almost half of the sample of respondents (44%) appears to be poorly adherent to treatment. Conclusions: impact of disease on the interviewee's activity is "high" or "very high" in the clear majority of patients with severe or moderate disease condition and the levels of adherence to therapies are very low. Improving patient adherence to inhalation therapy can lead to a better outcome for COPD treatment, with positive repercussions in terms of disease control, use of health services, positive impact on survival rate, patient’s quality of life and health care costs.

Keywords: COPD, Patient-reported outcomes, inhalation treatment, chronic illness, self-perceived health.

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (2), pp. 001-008, February, 2023. © International Scholars Journals

Keywords: Resistance training, child, obesity, review.

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (2), pp. 001-006, February, 2023. © International Scholars Journals

Keywords: Leukoplakia, Homogenous, Speckled.

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (1), pp. 001-006, January, 2023. © International Scholars Journals

Keywords: Hepatitis B, vaccine, rate, medical students

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (1), pp. 001-004, January, 2023. © International Scholars Journals

Full Length Research Paper

Cancer, prevention, research and the “calendar girls”

Raquel Mattos Bernardo^1,2, Milena de Oliveira Monteiro³, Ernani Costa Mendes⁴, Solange Campos Vicentini⁵, Nelson de Souza Pinto^1,6, Dulciane Nunes Paiva⁷, Sebastião David Santos-Filho¹, Mario Bernardo-Filho^1,4

¹Universidade do Estado do Rio de Janeiro, Instituto de Biologia Roberto Alcântara Gomes, Departamento de Biofísica e Biometria, Rio de Janeiro, RJ, Brasil.

²Universidade do Grande Rio, Curso de Medicina, Duque de Caxias, RJ, Brasil.

³Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

⁴Instituto Nacional de Câncer, Coordenadoria de Pesquisa, Rio de Janeiro, RJ, Brasil.

⁵Faculdade de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

⁶Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.

⁷Universidade Santa Cruz do Sul, Santa Cruz do Sul, RS, Brasil.

Accepted 08 October, 2022

Abstract

World Health Organization work towards the prevention, the research and control of cancer. Movies have been used, as tools in the primary prevention, to discuss important problems in Health Sciences. The aim of this work is to present the number of publications (NP) in research and prevention and cancer in a database system, as well as to discuss about a film that shows an interesting way to get money to aid the development of a social program against cancer. The searches (24/09/2012) were performed in PubMed using the word cancer alone or cancer and prevention or cancer and research and the NP was determined. The results have shown 2682867 publications about cancer, and 141115 publications about prevention and cancer and 935397 publications about cancer and research. Calendar Girls is inspired in a true story of the Yorkshire (UK) housewives who posed nude for a calendar. Julie Walters star as Annie, spurred into action when her husband (John Alderton) dies of leukaemia. To raise money for the hospital where he was treated, the woman persuades their friends to strip for a saucy and discreet charity calendar. The film shows the meaning of the interactive processes of cooperation, when it is touching the public opinion for humanitarian causes. The analysis of the NP shows the importance of the studies about prevention and research in relation with cancer. The analysis of the film shows the relevance of the simple and creative actions to obtain money.

Keywords: Cancer, Prevention, Research, Calendar girl, movie, PubMed.