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A Multilevel Exploration of Treatment Seeking Behaviour of Disabled Persons in India

机译：印度残疾人寻求治疗行为的多层次探索

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Treatment seeking behaviour of disabled persons is a complex phenomenon in the third world and largely unexplored in the country like India. This paper has been designed with an objective to find out the influence of different individual, household and state level factors in treatment seeking behaviour of disabled persons using the data from NSS 58th round-2002 disabled persons in India. More than one fifth of disabled persons have not received or presently not going for any treatment after the onset of disability in India. From the analysis it is well depicted that Individual as well as household and state level variables have a significant influence in deciding the treatment seeking behaviour of disabled persons. Introduction Disabled persons are the largest deprived group in the world mainly in the third world. To this group, because of physical as well as mental challenges, services and facilities available to the non-disabled are either deprived or limited. Consequently, they become the least nourished, the least healthy, the least educated, and the least employed. Disabled persons face long events of neglect, isolation, segregation, poverty, deprivation, charity and even humiliation. The plight of the disabled in India is not an exception. The immense responsibility for the care of the disabled is generally left to their families and a few institutions managed by voluntary organizations and the government. In this regard treatment seeking behaviour of disabled persons is a complex phenomenon and remains largely unexplored in India. Treatment seeking behaviour of disabled persons depends not only on socio-economic factors but also on cultural factors. Health care or treatment seeking behaviour is a central issue in all kinds of morbidity, since the duration of any symptoms increases the probability of severe morbidity and harmful sequelae. Illness or deviation from a state of health is mostly a subjective awareness of an individual the relief of which may be sought within or outside of medical and health facilities [1]. Illness behavior refers to the activities undertaken by individuals in response to symptom experience. It typically includes mental debate about the significance and seriousness of these symptoms, lay consultation, decisions about action including self-medication, and contact with health professionals [2]. A substantial proportion of people experience some symptoms of illness at any given point of time but these go unreported. Perception on health problem and health care services plays an additional influential role in treatment seeking behaviour. Perception has a well-recognized social and even ethnic dimension [2]. Perception of illness as well as treatment seeking behaviour has been found to vary with cultural, ethnic and socioeconomic difference [1]. Care seeking has been viewed as an interval requiring time for problem “appraisal” (assessment of the nature of the problem and the need for clinical care), as well as time to act on the decision to seek care. It has been labeled as the “procrastination” interval, although some factors that may contribute to delay are not within a patient's control. Socio-economic status, whether measured by education, income or other indices of social class, has long been known to be associated with attitudes and health care practices [3]. The impact of socio-economic status on symptoms, respiratory morbidity and mortality is important because it may influence behaviors towards health seeking also [4]. Patient compliance depends on many psychological and sociological factors and the interaction of patient's own ideas with the disease. Among behavioral aspects, most of the investigators have studied variables like where persons with symptoms go to seek help, who continues with the treatment and who are the defaulters? There has been hardly any attempt to study personal variables like perception about the disease and the primary actions that are taken to get relief. There a
机译：在第三世界，寻求残疾人的行为寻求治疗是一个复杂的现象，在像印度这样的国家中，很大程度上尚待探索。本文旨在通过使用印度NSS 2002年第58轮残疾人的数据，找出不同的个人，家庭和州水平因素对寻求残疾人行为的影响。印度残疾后，超过五分之一的残疾人尚未接受治疗或目前未接受任何治疗。从分析中可以很好地看出，个人以及家庭和州一级的变量在决定残疾人寻求治疗的行为方面具有重大影响。引言残疾人是世界上最大的贫困群体，主要在第三世界中。对于这一群体，由于身体和精神上的挑战，为残疾人提供的服务和设施被剥夺或受到限制。因此，他们成为营养最少，健康程度最低，教育程度最低和雇用最少的人。残疾人面临着被忽视，孤立，隔离，贫穷，贫困，慈善，甚至屈辱的长期事件。印度残疾人的困境也不例外。照料残疾人的巨大责任通常留给了他们的家庭以及由自愿组织和政府管理的一些机构。在这方面，寻求残疾人的行为寻求治疗是一个复杂的现象，在印度仍未得到充分探索。寻求残疾人的治疗行为不仅取决于社会经济因素，而且取决于文化因素。寻求医疗保健或寻求治疗的行为是各种发病率的中心问题，因为任何症状的持续时间都会增加发生严重发病率和有害后遗症的可能性。疾病或偏离健康状况通常是个人的主观意识，可以在医疗和保健机构内部或外部寻求救济[1]。疾病行为是指个人为响应症状经历而进行的活动。通常包括就这些症状的严重性和严重性进行精神辩论，进行咨询，就包括自我药物治疗在内的行动做出决定，并与卫生专业人员进行联系[2]。相当多的人在任何给定的时间点都经历过某些疾病症状，但没有报告。对健康问题和保健服务的理解在寻求行为的治疗中起着另外的影响作用。感知具有公认的社会甚至种族维度[2]。人们发现对疾病的认识以及寻求治疗的行为随文化，种族和社会经济差异而变化[1]。寻求治疗被视为一个间隔，需要时间来进行问题“评估”（评估问题的性质和对临床治疗的需求），以及采取行动决定寻求治疗的时间。尽管某些可能导致延迟的因素不在患者的控制范围内，但已将其标记为“通精间隔”。长期以来，社会经济地位，无论是通过教育程度，收入水平还是其他社会阶层指标来衡量，都与态度和卫生保健实践有关[3]。社会经济状况对症状，呼吸系统发病率和死亡率的影响很重要，因为它也可能影响寻求健康的行为[4]。患者的依从性取决于许多心理和社会因素以及患者自己的想法与疾病的相互作用。在行为方面，大多数研究者都研究了变量，例如有症状的人去哪里寻求帮助，谁继续治疗以及谁是违法者？几乎没有尝试研究个人变量，例如对疾病的看法以及为缓解疾病而采取的主要行动。有一个

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