Mickey C. Smith

Hypertension and stress: A preventive approach

Abstract The most common approach to hypertension treatment is medication. Medical treatment, however, has been plagued with serious problems regarding detecting cases and maintaining compliance. By definition, the high proportion of cases diagnosed as ‘essential hypertension’ points to our inability to identify the causes of hypertension. This suggests that a psychosocial rather than a medical approach is needed if prevention is to be obtained. Such a preventive approach, based on decreasing the effects of stress, is presented. The first step—identifying individuals over-reactive to stress—was tested using Spielbergers state-trait anxiety model. Employees in five industries were screened for high blood pressure. A systematic sample and all hypertensives (SBP ≥ 160 and/or DBP ≥ 95 mm Hg) completed the State-Trait Anxiety Inventory (STAI). A-Trait as a measure of individual reactiveness to stress showed a weak relationship to hypertension. A-State, a measure of situation specific anxiety, showed a strong relationship to blood pressure. Multiple regression analyses identified obesity and A-State as the two most important modifiable risk factors for inclusion in a preventive program.

Relations Between Price and Quality in Community Pharmacy

Two elements which are of primary importance to the consumer or to the health care practitioner are the quality and price of medical care delivered. The purpose of this study was to attempt to relate the two for one part of medical care—community pharmacy practice. The two are obviously related, if not in fact, then at least in traditional wisdom. Stated in a laymans way, the purpose of this study was to determine if, indeed, you get what you pay for in community pharmacy services. This was accomplished through the formulation of various hypotheses concerning the relationships between the cost and quality of pharmacy services. Null hypotheses were tested with regard to these relationships. Price and quality data for this study were collected by two “shoppers” in 50 community pharmacies.

The determinants of health services utilization in a rural community in Kenya

Abstract The principal objective of this paper is to delineate social, structural, and health policy aspects related to the use of childhood vaccinations in an area of Machakos, Kenya. Children who have had BCG and smallpox vaccinations are likely to have received all other immunizations. The scars of BCG and smallpox vaccinations were used to determine those children aged 0–4 years who had received preventive health care in the community. A multivariate analysis revealed six health behavior related components: demographic structure, cosmopoliteness, health consciousness, attitudes toward health care, awareness of modern health services and the presence of significant references. It is concluded that although the individual characteristics are important in the maintenance of health behavior and the use of preventive health services, the social structure and the health policy are far more important determinants of community health care.

An investigation of prescribed and nonprescribed medicine use behavior within the household context

The goal of this study was to study empirically individual and household characteristics and their relation to individual medicine use behavior. The study accounted for 40% of the variance in prescribed medicine use and 20% of the variance in nonprescribed medicine use behavior for 545 AFDC households in Northern Mississippi. Perceived morbidity was the primary mediator of medicine use and 57% of the explained variance in nonprescribed medicine use. Age was a significant contributor to the variance explained in prescribed medicine use behavior. The use of nonprescribed medicines by other members of the household also significantly enhanced individual nonprescribed medicine use. Although many of the other individual and household variables were significant predictors of medicine use behavior they contributed little to the total explained variance. Research concerning medicine use in the context of the household is in the initial stage of theory development.

Attitudes of pharmacy students towards psychosocial factors in health care.

An attitude scale was administered on a cross-sectional basis to pharmacy students in 3 professional years and alumni 1 year post-graduation. The instrument, previously used in a study of social awareness among Canadian health professional students, revealed, on application, that social attitudes tended to decline as students progressed through school. Students with prior degrees had generally higher scores. Male students generally held stronger views than did female students, whether favorable or unfavorable.

Drug Use Themes for Teachers of Health

Content analysis was conducted on twenty-one curriculum guides used in state health instruction programs. In grades 9–12, the major emphasis was placed on the applications and on the dangers of the use of medications. In grades K-8, safety considerations such as proper storage received more attention. There was little information on the mechanism of action of medications, even though the audience for the guides includes teachers. Aside from frequent mention of the value of immunizations, the benefits of modern medicines received comparatively little attention. The pharmacist was the most frequently mentioned health professional.

The Role of the Pharmacist in the Delivery of Family Planning Services to College Students

Abstract A survey was conducted among college students to determine their assessment of the potential of the pharmacist as a family planning counselor. Pharmacists were seen as an appropriate source of contraceptive information for many contraceptive methods, but few respondents had actually consulted a pharmacist. Pharmacists were viewed as competent to provide contraceptive information by a slight majority of the respondents, but only half indicated they would use the pharmacist as a source of this kind of information.

Physician and Patient Factors Associated with Differences in use of New Versus Established Therapeutic Agents

AbstractThe purpose of this study was to examine a secondary source of data and attempt to identify physician and patient related factors which are associated with the prescribing of new prescription drugs. Eight drugs introduced to the general market between January, 1977 and December, 1980 were selected as “new drugs” for study. Study drug utilization was compared to that of established drugs of the same therapeutic categories to determine whether there were significant differences in the relative frequencies of use between the new drugs and the established drugs with respect to physician and patient characteristics. The major conclusions of the study were 1 that treatment variables (the drug(s) examined, patient’s disease and the treatment setting) are important considerations in establishing an association between prescribing behavior and physician and patient characteristics; (2) the use of secondary data sources to study these associations can serve a limited but useful function in an overall, compr...

Validation of sick role rights for mental illness.

The rights and obligations of the sick role model are postulated as fundamental elements in the social control of illness behavior (2). However, after more than 25 yr. of research on the sick role, most dealing with individual sociodemographic variations and exceptions (1, 5), many questions still remain unanswered (4). The present exploratory study determined the effects of severity of mental illness and presence of a prescription medication (as validating mechanism) on individual evaluar~on of rwo rights components of the sick role, exemption from normal duties and obl~gat~ons and freedom from blame for ones illness condition. A convenience sample of 100 university students was given forms containing three vignettes, each describing an individual with a typical mental disorder: personality disorder, neurosis and psychosis. These were conceptualized to represent three major categories of mental illness along a severity dimension. Half of the students received the additional information that the subject had received a prescription medication for his condition. Severicy was significant for both the question of exemption from normal duties (PC.? = 14.87, p < .001) and the question of freedom from responsibility for ones condition (Fn.3 = 14.94, p < .001). Medication was also significant for both questions (K.1 = 4.31, p < .05; K.1 = 14.45, p < ,001). There was no significant interaction. The findings, if they were supported by larger, more representative studies, would lead us two directions. First, the lay public seems to be able to discriminate among levels of severity for mental disorders and is more likely to grant sick role rights accordingly (to those with more severe disorder). Second, patients who receive a prescription medication are ceteris paribus more likely to be granted these rights (3). This study suggests the importance of societys influences over the mechanisms of social control for illness behavior.