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Background: Sexually transmitted infections (STIs) and STI treatment remain a challenge in public health. There is little understanding of related factors influencing health seeking behaviour and delay of care among clinic attendees in Jamaica. Aim: To determine socio-demographic profile of clinic attendees with STI and identify factors associated with delay in seeking care for STI-related symptoms. Methods: A cross-sectional study was done. 201 adult patients presenting with STI symptoms from four health centres in Kingston and St Andrew were selected. A 24-item interviewer-assisted questionnaire was used to obtain data on socio-demographic characteristics, patients' symptoms and duration, previous STIs, knowledge of complications and seriousness of STIs, and factors influencing decision to seek medical care. Results: Almost 75% delayed seeking care for STIs. Recurrent STIs was identified in 41% of patients. 'Could not find time' was the most commonly reported reason for delay in seeking care (36%). Females were 3.4 times more likely to delay seeking care for STI symptoms than males (OR 3.42, 95% CI: 1.73–6.73). Those with primary level education and below were 5 times more likely to delay seeking care for STI symptoms than those with at least secondary level education (OR 5.05, 95% CI: 1.09–23.46). Participants viewed staff as confidential (68%) and 65% thought health-care workers spent adequate time during consultations. Conclusion: Lower education level and the female gender are associated with delay in seeking care for STI-related symptoms. These factors should be considered when developing interventions to reduce delay in care for STI-related symptoms. [ABSTRACT FROM AUTHOR]

This study sought to examine the internal consistency reliability and underlying factor structure of the Agency of Health Research on Quality Hospital Survey on Patient Safety Culture (AHRQ HSOPSC) in two large acute care hospitals in a developing country setting (Jamaica). A cross-sectional study was done among 328 doctors and nurses. Reliability (internal consistency) analysis was done for each of the 12 composites and the Cronbach's Alpha coefficients were reported. Principal axis factor analysis (PA) using Varimax rotation was done to identify the underlying factor structure. The Cronbach's Alpha coefficient was ≥ 0.60 in ten composites. 'Overall perception of patient safety' and 'staffing' had Cronbach's Alpha values of 0.585 and 0.553 respectively. A ten-factor solution (34 items) with factor loading of ≥ 0.40 is the best model fit, and composites are now named 'handoff and transitions/information exchange,' 'communication/feedback,' 'frequency of events reported,' 'management support for patient safety,' 'teamwork in unit,' 'non-punitive response to errors,' 'overall perception of patient safety,' 'supervision/management expectations and actions promoting patient safety,' 'organizational learning - continuous improvement' and 'staffing'. The AHRQ HSOPSC is generally reliable in this developing country setting and the ten-factor structure is consistent with suggested modifications for the emergent AHRQ HSOPSC Version 2 tool. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine and characterize caregiver burden among caregivers of community-dwelling older persons in Jamaica. Method: A nationally representative cross-sectional study was done among persons providing noninstitutional care for a single person (≥60 years). The Zarit Burden Interview (ZBI) and a structured questionnaire were administered to 180 caregivers from four geographic health regions. Results: The ZBI scores ranged from 0 to 56 (median = 15). Independently associated factors were relationship to care recipient and age. Children/grandchildren had higher caregiver burden scores than formally employed caregivers (odds ratio = 2.9: 95% confidence interval: [1.02, 8.34]). Compared with caregivers 35 to 44 years, those aged 45 to 65 were almost 5 times more likely to report higher caregiver burden scores. Conclusion: Caregiver burden as identified by the ZBI was low. Age (45–65 years) and being the child/grandchild of the care recipient were independently associated with greater caregiver burden. Interventions to address caregiver burden must embrace strategies that recognize that these factors. [ABSTRACT FROM AUTHOR]

Objective: To examine the performance of the Mini-Mental State Examination (MMSE) in community-dwelling older persons in a developing country (Jamaica) undergoing rapid population aging.Methods: An embedded validity study was conducted utilizing participants from a nationally representative sample of 2782 older persons. Standardized MMSE scores were obtained for study participants. A random selection of 170 persons with MMSE scores greater than 20 and 170 persons with scores 20 or less was done. Field staff were trained to apply the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for the diagnosis of dementia. In total, 300 participants (167 participants with MMSE score of 20 or less, 133 participants with scores greater than 20) were assessed and categorized according to dementia status. Performance characteristics of the MMSE tool were determined for study participants and appropriate adjustment and analyses subsequently applied to facilitate extrapolation to the nationally representative sample.Results: The mean MMSE scores for participants with score of 20 and less was 17.1 (standard deviation [SD] = 3.2) and 24.5 (SD = 2.8) for those with scores greater than 20. Dementia was identified in 34 participants. The receiver operating characteristic curve for MMSE scores in relation to dementia diagnosis had an area under the curve value of 0.935 (95% confidence interval, 0.893-0.977). The optimal MMSE cut-point was 18/19 and was consistently so regardless of age category, gender, educational level, and number of chronic illnesses.Conclusion: There is merit in using the MMSE examination as a screening tool for dementia in Jamaica. The findings of this study coupled with widespread use and familiarity among practitioners give credence to the MMSE as a reasonable screening tool for dementia in Jamaica-rapidly aging society. [ABSTRACT FROM AUTHOR]