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Objective: Africa contributes significantly to the increasing global prevalence (>37 ​%), unmet need and treatment burden for people with osteoarthritis. Despite this, little research has examined the expressed needs of patients with osteoarthritis (OA) and joint pain in West-Africa. This study aimed to explore lived experiences, expressed needs and current care gaps for people living with osteoarthritis in low-health resource contexts using Nigeria as a case study. Design: Qualitative study using Focus Groups. People aged 45 years and over living with osteoarthritis and joint pain were recruited at local health services or via wide advertisements in the community. Discussions were recorded and transcribed verbatim. Data were analyzed using thematic analysis (inductive approach). Results: Three focus groups were conducted with people living with osteoarthritis (n ​= ​30, age range 45–90 years) across socio-demographic strata. Participants described their experiences of living with osteoarthritis as emotionally, physically, and socio-economically challenging. Four main themes (and 14 sub-themes) were identified. Participants expressed the need for an information and health education campaign and access to appropriate health professionals (especially physiotherapists) for providing support, guidance, and assistance with self-management. Conclusions: The provision of an accessible, and contextually appropriate patient education package, in line with evidence-based recommendations is a critical need for people living with osteoarthritis in Nigeria. This will promote evidence-based care for OA in low-resource settings, empowering patients to self-manage and reducing confusion related to inconsistent advice and mixed messages about cause, healthcare access and OA care.

Caregivers of people with disability experience difficulties in a variety of care domains. Understanding the predictive factors of caregiver strain is important in developing and implementing evidence-based intervention to reduce the difficulties experienced by the carers. The current study is a cross sectional comprehensive one-phase survey conducted in randomly selected sub-districts (taluks) of the Ernakulam district in Kerala. Primary caregivers (n = 851) for persons with different kinds of disability were identified with the help of ASHAs (Accredited Social Health Activities) from the selected geographical locations and were interviewed in a house-to-house survey after obtaining written informed consent. Validated tools measuring caregiver strain, financial burden, access to services and wellbeing were used to study the population. Majority of the caregivers were females (77.3%) and spouses (35.2%). Of the caregivers 27% reported high levels of caregiver strain. The major factors associated with caregiver strain were female gender (B = 1.379, p = 0.000), financial issues (B = 0.105, p = 0.000), the general health of caregivers (B = 0.467, p = 0.000) and issues relating to employment (B = 0.956, p = 0.000) and the availability of government welfare services (B = 1.138, p = 0.000). High caregiver burden and strain is experienced by almost a third of people caring for a person with a disability. Comprehensive interventions to reduce caregiver strain should be developed. The rehabilitation sector needs to be made aware of the high levels of caregiver strain (especially in carers who were female, unemployed, have health issues and lack formal support). To improve wellbeing for people with disability we firstly need to promote social inclusion and support schemes for caregiver. Co-designed systems are needed to assist carers to access formal and informal support resources, and increase social connectedness. [ABSTRACT FROM AUTHOR]

This study analyses the expressed sexuality education needs of young people from Azuay, a region of Ecuador characterised by a large proportion of young people whose parents have migrated abroad, a group often considered at risk to developing of sexual health problems. Multi-stage stratified cluster sampling was used to recruit young people aged 11 and 19 years to the study. The expressed needs of participants were analysed in relation to gender, parents’ migratory status, age and geographical location. Survey findings revealed that young people expressed high needs with respect to the different components of Comprehensive Sexuality Education: gender roles, sexual and reproductive health, sexual citizenship, pleasure, violence, diversity and relationships. Ordinal regression analyses revealed few significant differences in relation to socio-demographic variables, which was surprising, in particular, with respect to the group of young people with migrating parents. Given the high levels of expressed needs, the findings carry important implications for the design and implementation of future sexuality education programmes. [ABSTRACT FROM PUBLISHER]

Objective: Meeting the needs of clients receiving substance use services is related to program engagement and retention. Using Bradshaw's (1972) classic taxonomy of needs as a framework, the purpose of this study was to determine the relationship between clients' expressed needs for their treatment experiences as compared to their formally assessed or normative needs. How expressed needs are related to demographic and other characteristics and program exit status was also explored. Methods: Secondary analysis of evaluation data gathered for other purposes was utilized. Data including demographic and drug use variables were obtained from client charts (N = 237) in a residential treatment agency serving women with co-occurring disorders who were homeless. Clients were administered the Addiction Severity Index-Multimedia Version (ASI-MV) to assess treatment or normative needs. They were also asked to complete the 69-item needs assessment questionnaire, "What I Want From Treatment" (Miller & Brown, 1994). Items that had the highest mean scores were submitted to a principal components analysis for data reduction to determine expressed needs. Bivariate analyses were used to determine the relationships between three expressed needs factors (alcohol/drug, psychological, and housing/employment) and ASI composite scores, demographic characteristics, and exit status. Results: There was no relationship between expressed needs and ASI scores except between the housing/employment factor and medical needs. Race, ethnicity, criminal justice status and drug of choice had no relationship to expressed needs. Those who were referred by a community agency had higher scores on the alcohol/drug factor as compared to those who were self-referred or referred by the criminal justice system. Clients receiving psychiatric medications were less likely to ask for help on psychological and housing/employment factors. There was no association between expressed needs at intake and program exit status. Conclusions: Race and supervision status did not appear to be barriers to asking for help. Clients' expressed needs were not related to the severity of their assessed problems, indicating that separate constructs were being measured. Including both expressed and assessed needs may be important in holistic treating planning and intervention. [ABSTRACT FROM AUTHOR]

Objective: We have undertaken a cross-sectional study to assess factors associated with dental pain that determine the expressed needs for dental care among 12-year-old school children in India. Materials and Methods: A total of 2 250 school children were surveyed after being drawn through stratified cluster random sampling. The simultaneous effects of sociodemographic characteristics, pain characteristics, and the impact of pain on the quality of life were studied in association with the expressed needs for dental treatment. Results: Among the studied school children, 71.4% suffered from dental pain, only 27.7% expressed need for dental healthcare. Socioeconomic status (SES) was a statistically significant determinant. Pain characteristics like the severity of pain and pain on eating hot and cold foods were significantly associated with expressed needs. Impact characteristics associated with expressed needs were embarrassment in showing teeth, brushing teeth, and difficulty in eating and drinking. Logistic regression analysis yielded a Nagelkerke R² value of 0.106. Conclusion: Important determinants of expressed needs for dental care among the studied population were SES, pain intensity, pain on thermal stimuli, impact characteristics like eating/drinking and embarrassment in showing teeth. [ABSTRACT FROM AUTHOR]

Studies have reported that race/ethnicity, socioeconomic status, access to care, early diagnosis, quality of care, and spirituality are important prognostic factors for a breast cancer diagnosis. This exploratory study seeks to identify the perceived needs of Black middle-income breast cancer survivors. The Delphi Technique, a qualitative research approach (for deriving cultural consensus), was used to assess needs of 62 Black middle-income socioeconomic position survivors. Survivors' expressed needs were to have (1) affordable, accessible, acceptable, and appropriate medical and support services; (2) a caring and loving family; (3) contacts for information regarding breast cancer symptoms or related health problems; (4) an intimate relationship with God; and (5) adequate resources for self and family care. This pilot study suggests Black breast cancer survivors, regardless of a middle-income socioeconomic position (SEP), experience similar socioecological stressors as low-income SEP survivors. [ABSTRACT FROM AUTHOR]

Objective: We have undertaken a cross-sectional study to assess factors associated with dental pain that determine the expressed needs for dental care among 12-year-old school children in India. Materials and Methods: A total of 2 250 school children were surveyed after being drawn through stratified cluster random sampling. The simultaneous effects of sociodemographic characteristics, pain characteristics, and the impact of pain on the quality of life were studied in association with the expressed needs for dental treatment. Results: Among the studied school children, 71.4% suffered from dental pain, only 27.7% expressed need for dental healthcare. Socioeconomic status (SES) was a statistically significant determinant. Pain characteristics like the severity of pain and pain on eating hot and cold foods were significantly associated with expressed needs. Impact characteristics associated with expressed needs were embarrassment in showing teeth, brushing teeth, and difficulty in eating and drinking. Logistic regression analysis yielded a Nagelkerke R 2 value of 0.106. Conclusion: Important determinants of expressed needs for dental care among the studied population were SES, pain intensity, pain on thermal stimuli, impact characteristics like eating/drinking and embarrassment in showing teeth.