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Investigating factors of self-care orientation and self-medication use in a Greek rural area.

INTRODUCTION
Self-care oriented people are more likely to undertake self-care activities in order to treat lay self-diagnosed symptoms and restore their own health without professional assistance. One of these activities is self-medication, which refers to the use of medications without medical consultation. The absence of permanent doctors in rural Greece encourages self-medication practices. The main objectives of this article were to detect factors that determine self-care orientation and to predict the use of prescription medications without a doctor's prescription as well as to study the impact of self-care orientation in using medical care in a Greek rural area.


METHODS
A cross-sectional study was designed and 150 face-to-face interviews were randomly conducted during January and February 2011, by using a research instrument with 46 questions. These included information about self-rated health, existence of chronic disease, self-medication behavior, use of prescription and non-prescription drugs and sociodemographic characteristics of the respondents. Logistic regression as well as Fisher's exact test were used to analyze the results.


RESULTS
The majority of the respondents (80%) were found to be self-care oriented and 54.7% had used prescription medications without a doctor's prescription. The orientation to self-care seems to be determined by gender (p < 0.05), the existence of chronic disease (p < 0.05) and educational level (p < 0.05). More specifically, factors found to predict self-care orientation by using a medication and consequently self-medication were female gender (odds ratio (OR): 3.44, 95% confidence interval (CI): 1.37-8.66), the absence of chronic disease (OR: 0.30, 95% CI: 0.098-0.92) and higher educational level (OR: 1.64, 95% CI: 1.05-2.58). However, self-care orientation was not found to affect the use of medical services (p(Fisher's exact test)>0.05). The likelihood of using prescription medications without a doctor's prescription is defined by self-care orientation (p < 0.001) and self-rated health status (p < 0.05). So, individuals who practice self-medication with prescription drugs are self-care oriented (OR: 6.16, 95% CI: 2.38-15.89) and they probably have lower self-rated health status (OR: 0.65, 95% CI: 0.42-0.99).


CONCLUSIONS
The high percentages of self-care orientation and self-medication with prescription drugs highlight the need to educate individuals in rural areas about the safe and rightful use of medicines. Knowing what factors determine such self-medication will help in focusing and operationalizing future interventions to protect the health of the public.