High prevalence of undiagnosed cases of diabetes mellitus and poor knowledge, awareness, and practice has increased premature death, costly complications, and financial burden. A cross-sectional survey was conducted in November 2014 on 273 diabetics and 355 nondiabetics in 3 government homeopathic hospitals in West Bengal, India. A self-administered questionnaire assessing knowledge, awareness, and practice related to diabetes was used. A total of 17.5% to 29.3% of the participants were aware of the normal blood sugar level. Lack of insulin, frequent urination, hypertension, and poor wound healing were identified most frequently as the cause, symptom, association, and complications. A total of 35.5% to 46.5% said that diabetes was preventable; 14.1% to 31.9% knew that diabetes was controllable rather than curable. Consumption of planned diet, avoiding sugar, and testing blood sugar were the most frequently identified components of healthy lifestyle, diabetic diet, and diagnostic domain. Diabetics had higher knowledge and awareness than nondiabetics (P < .0001); still the latter need to be made aware and knowledgeable to curtail the ever-increasing burden of diabetes.
The American Patient Activation Measure-22 questionnaire (PAM-22) quantifies the knowledge, skills, and confidence essential to manage own health and health care. It is a central concept in chronic illness care models, but studied sparsely in homeopathic hospitals. PAM-22 was translated into Bengali and a cross-sectional study was undertaken in chronically ill 417 patients visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, India. Response rate was 90.41%. Data were analyzed using Rasch rating scale model with Winsteps. Activation score was 54.7 ± 8.04 or 62.13% of maximum score. PAM scores differed significantly by age, education, income, and health status (P < .05). The items had good data quality fit statistics and good range of difficulty. The construct unidimensionality was confirmed by good model fits for Rasch model and principal component analysis of residuals found no meaning structure. The questionnaire showed acceptable psychometrics. Patient activation was moderate and needs to be improved.
There is lack of studies assessing the preference of Indian patients for integration of homeopathy into standard therapy settings. The objectives of this study were to examine the knowledge, attitudes, and practice of homeopathy among Indian patients already availing homeopathy treatment and its integration into mainstream healthcare.A cross-sectional survey was conducted among adult patients attending the out-patients of the four government homeopathic hospitals in West Bengal, India. A self-administered 24-items questionnaire in local vernacular Bengali was developed and administered to the patients.A total of 1352 patients' responses were included in the current analysis. 40% patients thought that homeopathic medicines can be used along with standard therapy. 32.5% thought that homeopathic medicines might cause side effects, while only 13.3% believed that those might interact with other medications. Patients' knowledge ranged between 25.1 and 76.5% regarding regulations of practicing and safety of homeopathic medicine in India and abroad; while positive attitude towards the same ranged between 25.4 and 88.5%. 88.6% of the patients had favorable attitude toward integrated services. 68.2% of the patients used homeopathic medicines in any acute or chronic illness for themselves and 76.6% for their children. Preference for integrated services was significantly associated with better knowledge (P = 0.002), positive attitudes toward safety and regulations (P < 0.0001), and integration (P < 0.0001), but not with the level of practice (P = 0.515).A favorable attitude toward integrating homeopathy into conventional healthcare settings was obtained among the patients attending the homeopathic hospitals in West Bengal, India.
Background and aims: Self-medication is mostly prevalent in the low- and middle-income population segments of developing countries, thus reflecting the status of health services. Self-medication has frequently been held responsible for inducing drug resistance, higher cost of further treatment, and other complications. The World Health Organization (WHO) promotes self-medication in rural and remote areas to reduce the burden of health services. In this study, the researchers sought to establish the prevalence, consequences, and causes of self-medication. Methods: Multicenter, institution-based, cross-sectional study conducted with 456 participants in May, 2013 at the outpatient clinics of 2 Government homeopathic medical colleges in West Bengal, India. A pilot-tested structured questionnaire consisting of 12 self-administered questions in local vernacular Bengali was used; 8 were close-ended questions providing multiple answer options, while 4 were open-ended. Results: Overall, 12.7% of interviewees admitted to perform self-medication; 57.7% and 66.0% had appropriate knowledge of the medicines and dose regimens, respectively. Females (64.3%) predominated and self-medication was mostly found in age range 31-45 years old (32.5%). Conventional Western medicine (82.2%) was most preferred therapy, and fever (35.7%), hyperacidity (25.4%) and loose stool (24.3%) the most frequently reported complaints. The main causes for self-medication were feeling no need to consult doctor (32.5%), busy schedule (16.4%), family members advice (16.0%), over-the-counter (OTC) availability of medicines without prescription (12.5%), direct consumer pharmaceutical advertisement (12.1%), and high expenditure in private institutes (10.1%). The chi-square distribution of determinants across the two samples differed significantly. The tendency increased proportionately with literacy (Yates’ χ2=175.731; p=0.000) and poverty (Yates’ χ2=426.817; p=0.000). Conclusion: The results reflect the knowledge, attitude, and practice of self-medication among the participants. Further studies should be undertaken in larger samples and different populations.
Hering's Law Assessment Tool emerged as a systematic outcome assessment tool following homeopathic intervention. The authors intend to modify it and develop a new tool-Patient Response Assessment Tool after Homeopathic Treatment (PRATHoT)-in chronic cases through Delphi technique for systematic categorization of probable outcomes following individualized homeopathic treatment in chronic cases. The PRATHoT was drafted after literature review and iterative Delphi rounds with multidisciplinary expert panel, setting Fleiss κ of 0.41 to 1.00 a priori as the desired level of multirater agreement. Following pilot testing, the tool was implemented on 37 patients suffering from knee osteoarthritis over 6 months. Logistic regression analysis confirmed that higher PRATHoT score was significantly associated with achieving pain visual analogue scale responses from the second follow-up visit onwards (B = 0.037-0.066; SE = 0.021-0.036; P = .003-.048). The tool appeared to have acceptable psychometric properties; hence, it may be considered as a promising tool, amendable for further development.
Background and aims – This research was an attempt to understand the views of students of homoeopathic undergraduate schools in West Bengal, India and to identify areas of strength and weakness in the learning environment.
Methodology – An institutional, cross-sectional, observational study was carried out involving 430 students in May, 2013 in two Government homoeopathic medical colleges in West Bengal, India. A seven-item close-ended questionnaire with four point Likert scale was used to determine students’ perceptions of the learning environment, intellectual climate and teacher-student relationship in homoeopathic schools. The questionnaire generated seven subscales – flexibility, student to student interaction, emotional climate, supportiveness, meaningful experience, organization, and breadth of interest.
Results – 46.5% of students belonged to rural areas and Bengali was the mother tongue of 93.7% students. 39.5% preferred Bengali as the medium of instruction and group study was preferable to 77.9% students. 47.7% students were dissatisfied with the teaching process and 79.8% preferred the use of multimedia over conventional classroom teaching. Flexibility remained low (mean=1.9, SD=0.9); meaningful experience (theoretical teaching) score was high (mean=2.6, SD=0.9). Scores did not vary significantly (P>0.05) across the pre-clinical and clinical students, but few subscales produced significant differences individually among students of different years. Internal consistency scores of the scale remained questionable (Cronbach’s α 0.310-0.446); however, the scale showed acceptable test-retest reliability (Cohen’s κ 0.680-0.838).
Conclusions – This study emphasized the areas requiring improvement in homoeopathic school environment based on students’ perspective. Changes in curriculum, faculty and infrastructure should be planned to improve students’ satisfaction.
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