Health Seeking Behavior among Health Professionals

MBA - MHM

2010
Institute of Business Management
The objective of this research study is to explore the health seeking behavior among health professionals. It further described the attitude of health professionals towards treating their medical conditions and barriers which prevent them to seek formal medical help.

Health Seeking Behavior among Health Professionals

Course Title: Research and Survey Methodology

Faculty Name: Dr. Shahid Amjad

Project Members: Rozeena Gillani Dr. Mehwish Jannat Ali Dr. Tanzeela Khan 2010-3-26-10949 2010-3-26-11055 2010-3-26-10999

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TABLE OF CONTENTS
COURSE TITLE: RESEARCH AND SURVEY METHODOLOGY..................................2 TABLE OF CONTENTS.....................................................................................3 ACKNOWLEDGEMENT.....................................................................................4 ABSTRACT.....................................................................................................5 INTRODUCTION...............................................................................................................5 OBJECTIVES....................................................................................................................5 METHODOLOGY..............................................................................................................5 RESULTS.........................................................................................................................5 CONCLUSION..................................................................................................................6 INTRODUCTION..............................................................................................7 OBJECTIVES...................................................................................................8 METHODOLOGY.............................................................................................8 DATA ANALYSIS.............................................................................................9 RESULTS.......................................................................................................9 BASIC DATA....................................................................................................................9 ATTITUDE......................................................................................................................11 BARRIERS.....................................................................................................................12 DISCUSSION................................................................................................13 CONCLUSION...............................................................................................15 RECOMMENDATION......................................................................................15 REFERENCES................................................................................................16 APPENDIX ...................................................................................................17

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ACKNOWLEDGEMENT
First of all we would like to thank the Almighty, to make us able and capable to complete our work with full determination and courage. We owe our gratitude to Dr.Shahid Amjad for his guidance and encouragement throughout the course work. We are also grateful to our institution for the patronage and support we have received. We would like to offer our thanks to administrative department of Institute of Business Management for giving us time and data regarding students enrolled in the institution.

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ABSTRACT
INTRODUCTION
It is commonly seen that health professionals are at number one place in self administration of medicine and not seeking advice from physicians and experts during illness for oneself and for their families therefore being a medical professionals, there was an urge to know what is the perception of other health professionals currently pursuing management education from one of the reknown institutes of Pakistan that is Institute of Business Management.

OBJECTIVES
The objective of this research study is (a) to explore the health seeking behavior among health professionals, (b) It further describes the barriers to seek medical healthcare.

METHODOLOGY
The study was conducted on simple random sample of 25 MHM students of Institute of Business Management. A comprehensive questionnaire was used as a tool for the study and results were analyzed via SPSS v17.0.

RESULTS
It was seen that out of 25, most of the students were working in a hospital environment and most of them were females. The gender wise evaluation of self treatment showed that females were in an opinion of self treatment in the case of illness as compare of males. And the most commonly self administered drugs were analgesics and antibiotics. This was then supported by the behavioral analysis of health professional which showed that maximum percent of health professionals are satisfied with their own treatment rather than seeking advice from other expert and physicians.

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CONCLUSION
Through all the results obtained it is concluded that there were many significant barriers identified which discouraged health professionals to access formal healthcare. It is very important to address this issue in various medical fields to challenge the attitude and opinions of health professionals regarding lacking of health seeking behaviors. There is also a need of change in societys view that health professionals have to be healthy all the time. Society has to understand that health professional is also human being and they also need medical help to remain healthy.

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INTRODUCTION
Since beginning of the health profession, it is always been associated with various hazards including high risk of infection. In-fact, the practice of health professionals is considered to be many times greater prone to infections, mortality and medical emergencies. According to Doll & Peto (1997), 2 male doctors aged under 65 have slightly lower mortality than the national average, though it is still higher than that of all men in the same socio economic category mortality ratios. This is only the ratios of doctors, the other health professions are also not very safe Indeed, they are also affiliated with high risks of other diseases. Further, Doll & Peto (1997) discussed that there is already substantial evidence that some groups may experience different hazards, either because of nature of their work or because of the personal characteristics that led them to adopt it. Radiologists and radiotherapists have an increased risk of leukemia and other cancers, psychiatrists of suicide, laboratory workers of tuberculosis and general physicians of coronary thrombosis. Despite of several statistics shows that the professional of health are always at high risk for several mortalities, when doctors experience state of illness, they disregard the advice which they usually offer to their patients. In-fact, there is a less ratio among health professional to seek some formal medical help in the situation of own illness. According to Kian & Ray (2009), health seeking behavior refers to all those things, human do to prevent and to detect diseases in a asymptomatic stages, where as illness behavior refers to all those activities designed to recognize and explain symptoms after one feels ill, and sick role behaviors refer to all those activities designed to cure disease and restore health after a diagnosis has been made. In the community of health professional, it is now norm to working through illness and self treatment which is again the barrier to seek health care. Although, it is previously discussed that health professionals have overall lower
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mortality rate than the general population, still they are much prone for certain physiological and psychological problems. According to Davis et al, (2003), the impact of these illnesses may be exacerbated by a culture that discourages admission of health vulnerabilities. Most of the health professionals rationalized for not seeking the external medical help by accusing healthcare to be inappropriate and have lesser quality. Additionally, self treatment among health professional is also bi product of lack of health seeking behaviors which includes diagnosing, treating and prescribing for their own selves. Self treatment is the phenomena which also include undertaking informal, or corridor consultations and self referring to specialists. According to Richards (1999), self treatment is inappropriate because of its lack of objectivity. This research brief focuses on the health-seeking behavior among health professionals and to identify the factors contributing to delay in health.

OBJECTIVES
The aims of the study are:

To identify the rate of health seeking behaviors among MHM students in Institute of Business Management

To identify barriers to seek formal healthcare

METHODOLOGY
A quantitative study with cross sectional design was planned to conduct among Health Management students of Institute of Business Management (IoBM) during November 2010 to December 2010. The data was collected by using simple random sampling. Twenty five participants with age between 20 to 40 years regardless of gender were selected in the study. Both verbal and written consent was obtained from the participants.

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The students list was obtained from administrative department of Institution which was used for sampling purpose and data collection. The total students of MHM program, at the time of data collection, were about 250 and data collection was done on 10% of population that is 25 students. The inclusive criteria for recruiting the participants were: (a) student of MHM program, (b) currently enrolled in IoBM, (c) aged between 20 40 years. Data was collected through questionnaire by MHM students of IoBM. The questionnaire for data collection was developed under supervision of research faculty Dr. Shahid Amjad. Firstly, the questionnaire was pre-tested on group of 5 MHM students of IoBM for validation. Small modification was done after pre testing. The questionnaire consists of three modules that is demographic-socioeconomic characteristics, attitudinal data regarding health seeking behaviors, and barriers of health seeking behaviors.

DATA ANALYSIS
For this research study Statistical Package for the Social Sciences (SPSS) 17.0 was used. SPSS is a computer program used for statistical analysis. It is used by market researchers, health researchers, survey companies, government, education researchers, marketing organizations.

RESULTS
BASIC DATA
Over 25 questionnaires were filled by MHM student (currently enrolled) of Institute of Business Management, 16 were females and 9 were males. Of the 25 respondents, 5 were doctors, 6 were dentist, 6 were pharmacists, 4 were nurses, and 4 were other health professionals (See Table 01).

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Profession Doctors Dentists Pharmacists nurses other health professional Total

Frequency 5 6 6 4 4 25

Percentage 20 % 24 % 24 % 16 % 16 % 100 %

Table 01: Descriptive representation of distribution of profession Over the total respondents, 52% of respondents were working in hospital area, 24% were working in an industrial area, and 24% were associated with education field (see Figure 01).

Figure 01: Analysis of respondents on the basis of working sector It was also observed that the most commonly self administered drugs among health professional are the analgesics and antibiotics (See Figure 02).

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Figure 02: Data on Self Administration of drugs by MHM students On analyzing the data genderwise, it is evident from Figure 03 that females agree more on self treatment then males.

Figure 03: Analysis of Gender wise opinion on Self treatment

ATTITUDE
Table 02 shows the attitude of health professionals regarding self treatment to analyze their health seeking behavior.

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Attitude It is acceptable to: Self-treat acute, minor illness

Strongly Disagree

Disagree Agree

Strongly Agree

20%

20%

44%

16% 12%

Order diagnostic tests on self for 36% 24% 28% diagnostic and treatment purposes Table 02: Attitudinal data towards health seeking behaviors

It was observed that 56% respondents consult doctors when they usually get ill but 44% of health professionals dont turn up with their problem which is respectively high. Furthermore, it was found that mostly (60%) respondents agreed that it is acceptable to treat minor illness, but the same ratio (60%) were having more disagreement regarding acceptability of ordering blood test and diagnostic test for one self.

BARRIERS
During survey, many barriers were identified which usually hinders in seeking help towards health for health professionals which is briefly shown in Table 03. Barriers To Seek Healthcare Embarrassed if problem turned out to be minor Satisfied with own healthcare Concerned about confidentiality Time constraint Strongly Disagree 16% 0% 16% 4% Strongly Agree 4% 16% 8% 20% 0% 12% 32%

Disagree 24% 16% 24% 24%

Agree 56% 68% 52% 52%

Financial constraints 20% 40% 40% Doubts regarding appropriate 12% 24% 52% Healthcare provision Pressure from community: health 4% 16% 48% professionals must be healthy Table 03: Data regarding barriers to seek healthcare

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In the survey, it was observed that 84% respondents were satisfied with their own healthcare thats why they dont seek medical help from other healthcare. 60% respondents expressed feeling of embarrassment if the problem turn out to be minor where as 80% was having pressure from community that health professional must be healthy and treat their disease by own selves. Furthermore, 60% respondents had concerns regarding their confidentiality and 64% people had doubts regarding appropriate health care provision and not satisfied other healthcare. Time constraints (70%) and financial constraints (40%) were also highlighted barrier in the survey.

DISCUSSION
The sample taken to conduct the study is relatively small, so more vigilance is needed to generalizing the results. However, the results are comparable to other studies to get more verification. In our study, the rate of health seeking behaviors among health professional has been evaluated. The study further described the attitude of health professionals towards treating their medical conditions and barriers which prevent them to seek formal medical help. In the study, it was found that most health professional support the idea of self treatment rather than ordering diagnostic test. It is possible that the phenomenon of self treatment was influenced by various social and personal factors. During analysis, it was also noted that more female Health Professionals were supporting the idea of self treatment rather than other health professional. This significant results posing the issue of health in the above mentioned profession that it need more medical attention as this profession might be neglected one. The attitudinal data suggests that preferences for self treatment may also be associated with the feeling of embarrassment, if the illness is turned out to be minor. According to Davidson & Schattner (2003) also found that 71% of doctors described themselves as embarrassed when seeking another doctor. In

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our study, the barrier of embarrassment was reported by other health professional as well. Furthermore, the barrier like pressure from culture that health professional should be healthy also encouraged health professional to choose self treatment option. The study supports previous claims that the culture of medicine is a barrier to health professional seeking health care (Davis, et al. 2003). The perception that health professionals are more likely than other professionals to work through illness may be symptomatic of a culture in which an image of invincibility is encouraged and vulnerability is denied (Thompson, et al. 2001). This is very disturbing factors which must be playing role in delayed presentation of even serious diseases. Another emergent issue for not seeking medical help was concern regarding confidentially (60%). The issue of trust might be the significant barrier to seeking psychiatric and reproductive services. According to Davidson & Schattner (2003), confidentiality breaches, combined with professional attitudes discouraging admission of vulnerabilities, have been reported to influence health professionals reluctance to seek mental healthcare. Time constraint (72%) and financial constraints (40%) were also commonly reported as significant barriers to seek healthcare service. Margaret (2008) elaborated in one study that cost was a more complex barrier, involving direct and indirect costs including fees charged, time off, and access to disability and business insurance cover. As inflation rate is increasing with the changing of economies that is why cost would remain a significant barrier to health care access, even though health professionals are associated with upper socio economic class.

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CONCLUSION
In overall survey, there were many significant barriers identified which discouraged health professionals to access formal healthcare. It is very important to address this issue in various medical fields to challenge the attitude and opinions of health professionals regarding lacking of health seeking behaviors. There is also a need of change in societys view that health professionals have to be healthy all the time. Society has to understand that health professional is also human being and they also need medical help to remain healthy.

RECOMMENDATION
During research study, it was observed that limited data was available regarding health seeking behaviors among health professional in Pakistan. As it is very prevalent and emergent issue that is why it is suggested that more researches has to be conducted especially in Pakistan on national and institutional level in order to understand the subject matter in detail. The concept of avoiding self medication and self health seeking behavior should be included in the course of studies of medical and para-medical students. The credibility of health professionals also plays an important in trusting other health professionals to seek advice for health issues. For this, every health professional should commit with integrity and dignity with his profession and practice.

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REFERENCES
Chen, J. et al. (2008). Doctors personal healthcare choices: A cross-sectional survey in a mixed public/private setting. Bio Medical Central Public Health. 183(8), pp.1-7. Center, C. et al. (2003). Confronting depression and suicide in physicians. Journal of Americal Medical Association, 289, pp. 3161-3166. Thompson, W. et al. (2001). Challenge of culture, conscience, and contract to general practitioners care of their own health: qualitative study. British Medical Journal. 323, pp. 728 731. Davidson, S., & Schattner, P. (2003). Doctors health-seeking behavior: a questionnaire survey. The Profession. 179, pp. 302 305. Margaret, K., Geoffrey, M., Clavarino, A., & Doust, J. (2008). Doctors as patients: a systemic review of doctors health access and the barriers they experience. British Journal of General Practice. pp. 501 508. Doll, R., & Peto, R. (1977). Mortality among doctors in different occupations. British Medical Journal. 1, pp. 1433-1436. Kian, S., & Ray, N. (2009). A review of health seeking behavior: problems and prospects. Retrieved December 1, 2010 from http://www.vitaminbenefits.info/a-review-of-health-seeking-behaviorproblems-and-prospects/

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APPENDIX
Health Seeking Behavior among Health Professionals
Survey Questionnaire
Profession: _______________ Type of Workplace: _______________ _______________ Gender: _______________ Years of Experience:

General Health Seeking Perception

1. Do you consult a Physician when you get ill? Yes / No 2. If not, how do you treat your illness? 01 = nothing 02 = self medication 03 = visit physicians when condition gets worse

3. If Self Medicated, was it 01 = over the counter medications 02 = previously prescribed medication

4. What did you take? (Can choose more than one)

01 = antibiotics 02 = analgesics 03 = drugs for genitourinary system 04 = drugs for respiratory system 05 = drugs for gastrointestinal system 06 = drugs for cardiology disease 07 = drugs for orthopedic diseases 08 = drug for endocrine system (including contraceptives and hormonal replacement therapy) 09 = psychotropic drugs 10 = drugs for chronic illnesses (e.g. diabetes, hypertension ) 11 = others

Attitude Towards Seeking Healthcare

Strongly Disagree Disagree Agree Strongly Agree

It is acceptable to:
5. Self-treat acute, minor illness

6. Order diagnostic tests on self for

diagnostic and treatment purposes

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Barriers To Seek Healthcare

Strongly Disagree 7. Embarrassed if problem turned out to be minor 8. Satisfied with own healthcare 9. Concerned about confidentiality 10. Time constraint 11. Financial constraints Disagree Agree Strongly Agree

12. Doubts regarding appropriate Healthcare

provision 13. Pressure from community: health professionals must be healthy

---Thank You ---

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