راه توبه هر روش كه پويند خوشست وصل تو به هر جهت كه جويند خوشست سوي تو به هر ديده كه بينند نكوست

1. راه توبه هر روش كه پويند خوشست وصل تو به هر جهت كه جويند خوشست سوي تو به هر ديده كه بينند نكوست نام تو به هر زبان كه گويند خوشست

2. با عرض خسته نباشيد

3. Initial psychological responses to Influenza A, H1N1 ("Swine flu") Robin Goodwin , Shamsul Haque , Felix Neto and Lynn B 2009 Myers

4. Abstract Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses.

5. Methods 328 respondents completed a cross-sectional Internet or paper-basedquestionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption

6. Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001).

7. Results 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001).

8. Results Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%).

9. Results In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened.

10. Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

11. Background Our study sought to gather a snapshot of the attitudinal and behavioural responses during the early stages of a pandemic, knowledgeabout the differences between seasonal and pandemic flu, and those groups seen as most 'at risk' from infection. Understanding such attitudes and levels of knowledge may have important public health implications for information campaigns aimed at encouraging appropriate precautions against infection, while comprehending risk perceptions can help identify those groups most likely to be at risk of stereotyping and prejudice during a pandemic

12. Methods Participants and Procedure Following ethical approval by the relevant University ethics boards in London and Malaysia, data was collected from a total of 328 respondents (mean age 31.2, SD 13.37, 62% female). A paper version of the questionnaire was distributed in Malaysia, with students recruiting 180 respondents from their own classes, and community members from residential areas and local offices in Kuala Lumpur (age range 18-70, mean age 29.0 (SD 13.36), 59% female)).

13. Methods Validity &variabbility Questionnaire???

14. Methods N=328??

15. SAMPLE: Respondents were primarily from the UK and Portugal but also included 30 respondents living outside these countries and resident in Finland (19 respondents), Poland (6 respondents), Malta (3 respondents) and France (2 respondents). Ten non-European based residents were then removed from the online survey before analysis.

16. Questionnaire We used closed format questions for two questions assessing the purchase, or intention to purchase, specific items, such as face masks ("Have you already bought (or are you intending to buy) anything in preparation for a swine flu epidemic (e.g. face masks, food, tissues, cleaning materials)?" (yes/noresponses). We accompanied this with an open-ended question for those who indicated they had/intended to purchase an item ("what have you bought?") with responses categorised for frequency in Malaysia and Europe, with the most common categories reported below.

17. Questionnaire We also included the elderly and immune compromised, two groups at higher risk from seasonal influenzas. Respondents completed closed-format 3-point scales, indicating the extent to which they believed these groups were more at risk than me, the same risk as me or less at risk than me. Anxiety indicators were assessed through two closed-format questions assessing personal worries about catching the virus (measured on a 4-point scale, from very concerned to not at all concerned), as well as questions assessing friends and families' estimates of the risk (4 point scale, from very high to very low).

18. سوالات انتقادی 1) پرسش نامه توسط چه کسي و در چه سالي ساخته شده است؟ 2) روند طراحي پرسش نامه چگونه بوده است؟ 3) چه نوع اعتبار و پايايي براي پرسش نامه اندازه گيري شده است؟ اعتبار محتوی و سازه – پایایی با آلفای کرونباخ 4) چرا اين نوع اعتبار و پايايي اندازه گيري شده است؟ 5) آيا نحوه اندازه گيري اعتبار و پايايي و اعداد آن قابل قبول است؟

19. 6) پرسش نامه براي چه کساني از افراد جامعه(جنس، سن، سطح سلامت و بيماري، تحصيلات و کشور محل زندگي و ...) کاربرد دارد؟ 7) تعداد سوالات و نحوه نمره دادن چگونه است؟ 8) پرسش نامه چند بار، توسط چه کسي و يا چه کساني و در چه زمان هايي بازنگري شده است؟

20. 9) جهت دريافت اجازه استفاده و يا خريد پرسش نامه، چگونه مي توان با پژوهشگر طراح تماس گرفت؟ از طریق تماس تلفنی و پست الکترونیک 10) آیاپرسشنامه داراي مقدمه مي باشد؟ بلی 11) آيا مقدمه واضح و در رابطه با اهداف پژوهش، محرمانه ماندن اطلاعات، سازمان حمايت کننده تهيه شده است؟ بلی 12) آيا در مقدمه نحوه پاسخ دادن به سوالات به طور واضح توضيح داده شده است و در صورت نياز مثالي مطرح شده است؟ بلی

21. 13) آيا در تايپ سوالات به ظاهر پرسش نامه دقت شده است؟ بلی 14) آيا سوالات از ساده به دشوار و در راستاي اهداف پژوهش طرح شده است؟ 15)آيا در پرسش نامه از لغات ساده و قابل درک جامعه استفاده شده است؟ 16) آيا کيفيت دستوري، نگارش و املاي صحيح رعايت شده است؟ 17) آيا هر سوال تنها يک موضوع يا مفهوم را مطرح مي کند؟ 18) آيا سوالات بر اساس فرهنگ، مذهب، روحيه و ... جامعه مورد نظر طراحي شده است؟ 19) آيا بين سوالات رابطه منطقي وجود دارد؟

22. 20) آيا در سوالات عبارات منفي مضاعف به کار رفته است؟ 21) آيا تعداد گزينه هاي سوالات کافي مي باشد؟ 22) آيا تعداد سوالات پرسش نامه باعث ايجاد ناراحتي در خواننده مي گردد؟ 23) آيا سولات به گونه اي طراحي شده است که جهت پاسخ گويي به 15-10 دقيقه زمان احتياج مي باشد؟ 24) آيا سوالات شخصي در انتها مورد پرسش واقع شده است؟ 25) آيا در انتها حسن ختام وجود دارد از پاسخ دهنده تقدير و تشکر به عمل آمده است؟ 26) آيا رنگ پرسش نامه مناسب مي باشد؟ 27) آيا توزيع پرسش نامه به صورت حضوري صورت گرفته است؟

23. 28) آيا جهت پاسخ گويي به پرسش نامه ايجاد انگيزه شده است؟ 29) آيا ايجاد انگيزه به روش مناسبي فراهم شده است؟ خیر 30) آيا جهت پاسخ گويي از مسئولين کمک گرفته شده است؟ 31) آيا جهت پيگيري عدم بازگشت پرسش نامه، روش پيگيري در نظر گرفته شده است؟

24. Results As shown in table 1 approximately a third of respondents reported they would use public transport less (116/320) or had contemplated cancelling or delaying flights (124/312),

25. Results . Few (7%, or 10/148) claimed they had stopped or reduced their eating of pork as a result of the pandemic

26. Results??????????? Our Malaysian sample was drawn from one large city - Kuala Lumpur - and may therefore not be representative of other, more rural populations in that country.

27. Results??????????? . Self-report biases in questionnaire completion may mean that our respondents were unwilling to provide openly prejudicial responses, whilst our study in Europe was further limited by including only those who had access to the Internet

28. Conclusion??????????? Our findings suggest culture and individual anxiety are important predictors of behavioural responses to pandemic influenza, with higher levels of anxiety about swine flu in Malaysia compared to Europe, and with greater levels of behavioural change in Malaysia???????????.

29. Acknowledgements • We would like to thank HuiChiet, Wei Pyng and Melissa ShuenYun for their help in collecting the data in Malaysia, Hazel George for her assistance in the UK, and the two reviewers for their helpful comments. • References • Coker R: Swine flu: Fragile health systems will make surveillance and mitigation a challenge. • BMJ 2009, 338:b1791. PubMed Abstract | Publisher Full Text Return to text

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