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Differences in elderly stress levels before Covid-19 vaccination: History of exposure to Covid-19 reduces stress before vaccination
Diferencias en los niveles de estrés de los ancianos antes de la vacunación contra el covid-19: el historial de exposición al covid-19 reduce el estrés antes de la vacunación.
Kristian Budi Setiawana, Isna Hikmawatib,
Corresponding author
isnahikmawati@ump.ac.id

Corresponding author.
, Dita Pratiwi Kusuma Wardanic, Juanita Juanitad
a Nursing, Universitas Muhammadiyah Purwokerto, Indonesia
b Epidemiology, Universitas Muhammadiyah Purwokerto, Indonesia
c Medical Laboratory Engineering, Universitas Muhammadiyah Purwokerto, Indonesia
d Civil Engineering, Universitas Muhammadiyah Purwokerto, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">The coronavirus &#40;Covid-19&#41; epidemic first occurred in China at the end of 2019&#44; developed into a pandemic and almost the entire world reported cases in each of their respective countries&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> The Covid-19 outbreak was initially possible due to exposure to the same and common sources&#44; including mobilization abroad&#44; mobilization to areas with a high incidence of Covid-19&#44; the second cause due to massive person-to-person transmission&#46; Transmission can occur due to touch&#44; crowds in activities&#44; etc&#46;&#44; it is estimated that there are two types of causes of outbreaks &#40;common source and propagated source&#41; involved&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a> Various efforts were made by the government to suppress the development of Covid-19&#44; one of which was through the vaccination program&#46; However&#44; this program has many obstacles as evidenced by the dropout between dose 1 &#40;30&#46;45&#37;&#41; and dose 2 &#40;16&#46;69&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Data on vaccination coverage in Indonesia from dose 1 is 204&#44;600&#44;057 &#40;87&#46;19&#37;&#41;&#44; dose 2 is&#58; 171&#44;211&#46;122 &#40;72&#46;96&#37;&#41;&#44; dose 3 is&#58; 63&#44;629&#44;385 &#40;27&#46;11&#37;&#41;&#44; dose 4 is&#58; 622&#44;180 &#40;42&#46;36&#37;&#41;&#46; Based on this data&#44; it shows that there is vaccination coverage for each dose&#46; The same thing happened in the elderly group on vaccination Dose 1&#58; 18&#44;408&#44;494 &#40;85&#46;41&#37;&#41;&#44; dose 2&#58; 14&#44;891&#44;890 &#40;69&#46;09&#37; and dose 3&#58; 6&#44;731&#44;099 &#40;31&#46;23&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> The low vaccination coverage is a problem in itself&#44; because we all understand that there are great benefits from vaccination to prevent symptoms of COVID-19 and further protection in the event of more severe cases of COVID-19&#46; The results of previous studies concluded that several factors affect public acceptance of vaccination&#44; including the many types of new vaccines and doubts about the reliability of the manufacturers&#44; therefore it is necessary to provide easy vaccination service facilities and official recommendations from the government&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> COVID-19 vaccination has become a social norm and the importance of official information and intensive communication about vaccinations from the government so that people do not hesitate to join the vaccination program&#46;<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a> Data on vaccination coverage in Central Java for the elderly from dose 1 was 3&#44;037&#44;727 &#40;82&#46;51&#37;&#41;&#44; Dose 2 was&#58; 2&#44;519&#44;478 &#40;68&#46;44&#37;&#41;&#44; dose 3 was&#58;1&#44;102&#44;060 &#40;29&#46;94&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> The dropout&#44; one of which is from the elderly group&#44; especially in the elderly who are comorbid and Covid-19 survivors&#44; some cases are delayed&#46; In addition to comorbid factors and a history of exposure to covid-19&#44; the elderly are vulnerable so they are at risk of being affected by <span class="elsevierStyleItalic">immunization stress related response</span> &#40;ISRR&#41;&#46; The incidence of anxiety and stress in the elderly ahead of the vaccine&#44; also occurs in several other countries such as the UK and Turkey and it is one of the factors hindering vaccine acceptance&#46;<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a> Vaccine anxiety and hesitation are related to negative perceptions and distrust and various conspiracies or negative support from various parties&#46;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a> In this study we answered two questions&#58;</p><p id="p0010" class="elsevierStylePara elsevierViewall">1&#46; What are the characteristics of the elderly who participate in the covid-19 vaccination program&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">2&#46; How are the stress levels of the elderly different before the covid-19 vaccination&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Material &#38; Methods</span><p id="p0020" class="elsevierStylePara elsevierViewall">Observational research with the elderly study population who will be vaccinating against Covid-19 in the working area of the Bojong Purbalingga Public Health Center&#44; Central Java&#46; Sampling using random sampling&#44; inclusion criteria age 45&#8211;79&#44; with a total sample of 90 respondents&#46; The project team obtained written informed consent from respondents&#46; The research instrument used a questionnaire with questions about the distance to the vaccination location&#44; history of being exposed to Covid-19&#44; transportation to the vaccination site&#44; the presence of family as health workers and stress levels&#46; The stress level questionnaire was adopted from various disorders containing cognitive responses &#40;such as difficulty concentrating&#41;&#44; physiological responses &#40;such as shortness of breath&#44; dry lips&#44; excessive sweating&#41;&#44; feelings of fear&#44; anxiety&#44; trust in vaccination&#46; The instrument has been validated with a validation value between 0&#46;50&#8211;0&#46;92&#46; Data were analyzed descriptively with percentages&#46;</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Results</span><p id="p0025" class="elsevierStylePara elsevierViewall">Based on the Covid-19 vaccination data in <a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>&#44; data from January to June 2021 results in fluctuations in vaccination coverage&#44; this is due to the early stages of vaccination activities during the pandemic&#44; so there are not many vaccines available&#44; and priority is still on health workers and public servant&#46; <a class="elsevierStyleCrossRef" href="#t0005">Table 1</a> shows that most of them are 45&#8211;55&#8239;years old &#40;47&#46;8&#37;&#41;&#44; 23&#44;3&#37; of respondents had been exposed to Covid-19&#44; 18&#44;9&#37; came from families of health workers&#46; 64&#46;4&#37;&#44; transportation to the vaccination site is by motorbike with a distance of 61&#44;1&#37; 1&#8211;2 KM&#46; The stress level before vaccination was mostly in the mild category &#40;51&#44;1&#37;&#41;&#46; Tabel&#46;2&#44; the majority of female respondents were 56&#46;7&#37; with a moderate level of stress in this group of 33&#46;3&#37;&#46; The mileage is 61&#46;1&#37; with a distance of 1&#8211;2&#8239;km and the moderate stress level in this group is 26&#46;7&#37;&#46; In the variable History of exposure to Covid-19&#44; 76&#46;7&#37; had never been exposed and the percentage of moderate stress in this group was 33&#46;3&#37;&#46; The next variable is the presence of family members who work as health workers 81&#46;1&#37; do not have family health workers and the level of moderate stress in this group is 36&#46;7&#37; &#40;See <a class="elsevierStyleCrossRef" href="#t0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="t0005"></elsevierMultimedia><elsevierMultimedia ident="t0010"></elsevierMultimedia></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Discussion</span><p id="p0030" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>&#46; shows that the Bojong Health Center has implemented a 6-month vaccination program with 2973 doses of 1&#44; this is in line with the government&#39;s program for the success of vaccination coverage&#46; Various strategies have been implemented by the Indonesian government to overcome the impact of the pandemic&#44; both through economic recovery strategies and increasing the capacity of the health system&#46; One of them is through the provision of vaccines and the implementation of Covid-19 vaccination&#46; The provision of this vaccine is a form of support and commitment for the implementation of Covid-19 vaccination to the target of 208 million Indonesians in order to achieve community immunity and overcome the pandemic&#46; Data from the Ministry of Health shows that as of December 31&#44; 2021&#44; Indonesia has received 429&#46;2 million doses of eight vaccine brands&#44; consisting of CoronaVac&#44; Covid Bio&#44; Astra Zeneca&#44; Sinopharm&#44; Moderna&#44; Pfizer&#44; Janssen and Novavax and vaccination coverage has reached 79&#46;4&#37; for the first dose and 54&#46;68&#37; for the second dose&#46; This has exceeded the Word Health Organization target of 40&#37; of the population being fully vaccinated by the end of 2021&#46; For this effort&#44; Indonesia is currently listed as the fourth largest country in the world based on the number of people who have been vaccinated in the world&#46;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a> Various regulations to support the implementation of vaccinations have been issued&#44; including presidential regulation number 99 of 2020 article 1 paragraph 1 concerning Vaccine Procurement and Vaccination Implementation in the Context of Combating the 2019 Corona Virus Disease Pandemic &#40;Covid-19&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> Under normal conditions the use of vaccines usually takes at least 10&#8211;15&#8239;years&#44; starting from pre-clinical to clinical phases 1&#44; 2 and 3 and finally efficacy trials&#46; These phases are carried out sequentially&#44; this is what makes vaccination expensive&#44; while the development of Covid-19 vaccination is not as it should be&#44; because several phases are carried out simultaneously with very large costs&#46; Within months more than 30 vaccines had entered the clinical development stage&#46; The impact of the rapid development of vaccines is causing confusion in the public perception and concern about the safety and efficacy of these vaccines&#46; However&#44; the widespread use of safe and effective anti-Covid-19 vaccines is one hope for a return to &#8220;normal&#8221; life&#46;<a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a> Age characteristics are mostly middle age &#40;45&#8211;55&#8239;years&#41;&#46; This is a new finding&#44; meaning that many younger people experience stress from vaccination&#46; Stress is influenced by various factors&#44; one of which is age&#46; In the process of human development&#44; the older a person is&#44; the possibility of experiencing stress due to a decrease in various functions&#46;<a class="elsevierStyleCrossRef" href="#bb0065"><span class="elsevierStyleSup">13</span></a> In addition&#44; the elderly are one of the populations at risk for Covid-19 infection&#44; many deaths occur in patients over 60&#8239;years with comorbidities such as heart disease&#44; diabetes&#44; and other factors such as dyspnea&#44; neutrophilia&#44; decreased lymphocytes&#44; increased ultra-TnI and D-D&#46; dimer&#46; Early diagn&#243;stico and supportive care are essential for elderly patients&#46;<a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a></p><p id="p0035" class="elsevierStylePara elsevierViewall">The results showed that the stress level in women was higher than men&#46; Men and women are very different in responding to stress&#46; Women will easily experience stress because women are more sensitive to a response&#46; Women&#39;s brains have a negative response to conflict and stress&#44; in women conflict triggers negative hormones causing stress&#44; anxiety&#44; and fear&#46;<a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a> The same thing was concluded from the results of the study that gender differences were associated with side effects of vaccination and the percentage was more reported by women&#46; Most of the reported AE &#40;Adverse Events&#41; occur within 1&#8239;week after the first dose&#46;<a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a> The affordability of vaccination is very good&#44; with the highest percentage being 1&#8211;2 KM from health facilities that serve vaccinations&#44; it is aimed at the number of respondents with the closest distance&#44; it will accelerate the vaccination program to create herd immunity&#46; In accordance with PERMENKES No&#46; 10 of 2021&#44; the central government distributes vaccines to local governments which are then forwarded to health care facilities&#46;<a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a> Various ease of vaccination&#44; but not everyone is willing to be vaccinated shows the understanding of the public who are still doubtful about the effectiveness of vaccines in preventing the corona virus&#44; this is as the results of research which concludes that there are doubts and vaccine rejection of several types of vaccines&#46;<a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a> The same results were concluded from the UK National Health Service&#39;s study&#44; showing 18&#46;4&#37; refused vaccination and 10&#37; doubted the effectiveness of Covid-19 vaccination&#46;<a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a> The importance of building communication with the community by providing correct information about the Covid-19 vaccine&#44; can reduce doubts and people&#39;s refusal to be vaccinated&#46;<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a></p><p id="p0040" class="elsevierStylePara elsevierViewall">Based on the analysis of the difference in proportions&#44; it was found that respondents with a history of being exposed to Covid-19 or not having a history of being exposed to Covid-19 had the same stress when they were about to be vaccinated&#46; This is due to the bad stigma of the covid vaccine circulating in the community&#46; Fear&#44; anxiety&#44; and the abundance of information through social media&#44; not all of which can be trusted&#44; have created a negative stigma for people associated with Covid-19&#44; both Covid-19 patients&#44; Covid-19 suspects&#44; history of Covid-19 patients&#44; and others&#46; Health workers who treat Covid-19 patients&#46;<a class="elsevierStyleCrossRef" href="#bb0100"><span class="elsevierStyleSup">20</span></a> This is supported by the side effects of the vaccine&#44; while the side effects felt when the vaccine was administered were nausea&#44; cramps and even frequent drowsiness&#46; The seriousness felt when the vaccine was known to not exist&#44; only some informants said that if there were side effects&#44; and there were concerns that if the vaccine had been vaccinated&#44; it was possible that they could still get the Covid-19 virus&#46;<a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a> This is due to the transmission model of the Covid-19 virus&#44; so even after being vaccinated&#44; having contact with a person infected with SARS-CoV-2 substantially increases the likelihood of a positive test result for SARS-CoV-2&#46;<a class="elsevierStyleCrossRef" href="#bb0110"><span class="elsevierStyleSup">22</span></a> Even though it has been vaccinated&#44; it is hoped that the community will continue to maintain the process because the spread of this virus is so massive&#44; especially in people with comorbidities&#46; The results of the study show that diabetes and hypertension are the main comorbidities that pose a risk of death in Covid-19 patients&#46;<a class="elsevierStyleCrossRef" href="#bb0115"><span class="elsevierStyleSup">23</span></a> Another study concluded that people who were not vaccinated or only partially vaccinated were more at risk of transmitting the SARS-CoV-2 virus compared to people who were fully vaccinated&#46;<a class="elsevierStyleCrossRef" href="#bb0120"><span class="elsevierStyleSup">24</span></a></p><p id="p0045" class="elsevierStylePara elsevierViewall">The results of the study show that the incidence of stress experienced by the elderly in families who have members as health workers&#44; although the percentage is lower than those who do not have family members of health workers&#44; this is as the results of previous studies which concluded that anxiety is not only felt by the community&#44; but also experienced all health workers such as doctors&#44; nurses&#44; midwives and other health professionals&#46; The psychological response experienced by health workers to this infectious disease pandemic is increasing due to feelings of anxiety about their own health and the spread to their families&#46;<a class="elsevierStyleCrossRef" href="#bb0125"><span class="elsevierStyleSup">25</span></a> In addition&#44; there are still health professions that reject valuations&#44; in the country of lebanon&#44; 18&#37; of Health workers refuse vaccination&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> To reduce the stress response&#44; it is necessary to assess the feasibility of the vaccine&#46; This is because the vaccines used are relatively new and to ensure patient safety is maintained&#46; Assessment of a person&#39;s health condition through screening medical history with anamnesis&#47;interviews can screen for conditions that are not eligible for vaccines&#44; for example someone who has comorbid hypertension or uncontrolled diabetes mellitus is not allowed to receive vaccines for patient safety&#46;<a class="elsevierStyleCrossRef" href="#bb0130"><span class="elsevierStyleSup">26</span></a> Limitations in this study&#44; some of the respondents were exposed to Covid-19 and had families of health workers&#44; so that it more or less affected readiness in Covid-19 vaccination activities&#46; Further research needs to be carried out interventions in relaxation techniques ahead of vaccination&#44; especially in advanced vaccination doses&#44; so that the incidence of stress in the elderly can be minimized&#46;</p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0085">Conclusions</span><p id="p0050" class="elsevierStylePara elsevierViewall">The results showed that the level of stress in the moderate category was at most in middle age by 22&#46;2&#37;&#44; women 33&#46;3&#37; had higher stress levels than men &#40;10&#37;&#41;&#44; vaccination coverage was at moderate stress levels&#44; the highest was 26&#46;7&#37;&#46; at a distance of 1&#8211;2&#8239;km&#46; The stress level was 33&#46;3&#37; higher in the elderly who had never been exposed to Covid-19&#44; compared to those who had a history of being exposed to Covid-19 &#40;10&#37;&#41;&#46; Non-family health workers&#44; 36&#46;7&#37; higher than families of health workers &#40;6&#46;7&#37;&#41;&#46; There is a difference in the proportion of stress levels in the elderly on the variables of age&#44; gender&#44; distance from the vaccine site&#44; history of exposure to Covid-19 and family of health workers&#46; The need for family assistance to prepare for vaccination in the elderly&#44; besides that Health Officers are expected to provide clear information before vaccination activities&#44; especially for the elderly to reduce stress levels&#46;</p></span></span>"
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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Background</span><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">The Covid-19 pandemic requires the government to take various prevention and countermeasures&#44; one of which is the Covid-19 Vaccination program&#44; however&#44; the program experiences a high dropout at various doses and causes <span class="elsevierStyleItalic">immunization stress related response</span> &#40;ISRR&#41;&#44; especially in the elderly&#46; The research aims to determine differences in the stress levels of the elderly before the covid-19 vaccination&#46;</p></span> <span id="as0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Methods</span><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Descriptive study with the elderly population who will take vaccinations at the Bojong Purbalingga Health Center&#46; Sampling used random sampling&#44; the inclusion criteria were 45&#8211;79&#8239;years old&#44; with a total sample of 90 respondents&#46; Research instruments developed by research&#44; relating to vaccination containing cognitive responses &#40;such as difficulty concentrating&#41;&#44; physiological responses &#40;such as shortness of breath&#44; dry lips&#41; feelings of fear&#44; anxiety&#44; trust in vaccination&#46; Data were analyzed descriptively with percentages and proportions&#46;</p></span> <span id="as0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Results</span><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">The results showed that the most moderate stress levels were middle age &#40;22&#46;2&#37;&#41;&#44; women 33&#46;3&#37; had higher stress levels than men &#40;10&#37;&#41;&#44; the highest vaccination coverage was 26&#46;7&#37; at a distance of 1&#8211;2 KM&#46; The level of stress is in the moderate category 33&#46;3&#37; in the elderly who have never been exposed to Covid-19 and 10&#37; in the elderly who have been exposed&#46; Non-family health workers&#44; 36&#46;7&#37; higher than families of health workers &#40;6&#46;7&#37;&#41;&#46;</p></span> <span id="as0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Conclusion</span><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">Stress levels before vaccination are higher in the elderly who have never been exposed to Covid-19&#44; compared to those who have been exposed to Covid-19&#46; The need for family assistance to prepare for vaccination in the elderly&#46;</p></span>"
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        "resumen" => "<span id="as0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Antecedentes</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">La pandemia de Covid-19 requiere que el gobierno tome varias medidas de prevenci&#243;n y contramedidas&#44; una de las cuales es el programa de vacunaci&#243;n de Covid-19&#44; sin embargo&#44; el programa experimenta una alta deserci&#243;n en varias dosis y provoca una respuesta relacionada con el estr&#233;s de la inmunizaci&#243;n&#44; especialmente en el anciano&#46; Die Forschung zielt darauf ab&#44; Unterschiede im Stresslevel &#228;lterer Menschen vor der Covid-19-Impfung festzustellen&#46;</p></span> <span id="as0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">M&#233;todos</span><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo con la poblaci&#243;n adulta mayor que se vacunar&#225; en el Centro de Salud de Bojong Purbalingga&#46; El muestreo utiliz&#243; un muestreo aleatorizado&#44; los criterios de inclusi&#243;n fueron de 45 a 79 a&#241;os&#44; con una muestra total de 90 encuestados&#46; Instrumentos de investigaci&#243;n desarrollados por la investigaci&#243;n&#44; relacionados con la vacunaci&#243;n que contienen respuestas cognitivas &#40;como dificultad para concentrarse&#41;&#44; respuestas fisiol&#243;gicas &#40;como dificultad para respirar&#44; labios secos&#41; sentimientos de miedo&#44; ansiedad&#44; confianza en la vacunaci&#243;n&#46; Los datos fueron analizados descriptivamente con porcentajes y proporciones&#46;</p></span> <span id="as0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Resultados</span><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">Los resultados mostraron que los niveles de estr&#233;s m&#225;s moderados fueron la mediana edad &#40;22&#44;2&#37;&#41;&#44; las mujeres 33&#44;3&#37; presentaron niveles de estr&#233;s m&#225;s altos que los hombres &#40;10&#37;&#41;&#44; la mayor cobertura de vacunaci&#243;n fue 26&#44;7&#37; a una distancia de 1&#8211;2 KM&#46; El nivel de estr&#233;s est&#225; en la categor&#237;a moderado 33&#44;3&#37; en ancianos que nunca han estado expuestos al Covid-19 y 10&#37; en ancianos que han estado expuestos&#46; Trabajadores de la salud no familiares&#44; 36&#44;7&#37; superior a los familiares de los trabajadores de la salud &#40;6&#44;7&#37;&#41;&#46;</p></span> <span id="as0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Conclusi&#243;n</span><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">Los niveles de estr&#233;s antes de la vacunaci&#243;n son mayores en los adultos mayores que nunca han estado expuestos a Covid-19&#44; en comparaci&#243;n con aquellos que han estado expuestos a Covid-19&#46; La necesidad de asistencia familiar para preparar la vacunaci&#243;n en los ancianos&#46;</p></span>"
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                  \t\t\t\t">47&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Famale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Education Level</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elementary school&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Middle school&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High school&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Distance Traveled</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#8211;2 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#8211;4 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5&#8211;6 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>6 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">History of Covid-19</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family of Health Workers</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transportation</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Walk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bicycle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Motorcycle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Car&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Public Transport&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stress Level</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Light&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Strong&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Characteristics of Elderly Participants With Dose 1 Vaccination&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "t0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0015"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Light</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Medium</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Strong</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#8211;55&#40;Middle Age&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#8211;66&#40;Eldery&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#8211;79&#40;Young Old&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Distance Traveled</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#8211;2 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#8211;4 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5&#8211;6 Km&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>6 Km&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="9" align="" valign="\n
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                            2 => "Xingwang Li"
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                            5 => "Yi Hu"
                            6 => "Li Zhang"
                            7 => "Guohui Fan"
                            8 => "Jiuyang Xu"
                            9 => "Gu Xiaoying"
                            10 => "Zhenshun Cheng"
                            11 => "Ting Yu"
                            12 => "Jiaan Xia"
                            13 => "Yuan Wei"
                            14 => "Wenjuan Wu"
                            15 => "Xuelei Xie"
                            16 => "Wen Yin"
                            17 => "Hui Li"
                            18 => "Min Liu"
                            19 => "Yan Xiao"
                            20 => "Hong Gao"
                            21 => "Li Guo"
                            22 => "B&#46;C&#46; Jungang Xie"
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Article information
ISSN: 15769887
Original language: English
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2024 February 11 3 14
2024 January 10 0 10
2023 December 13 0 13
2023 November 9 0 9
2023 October 24 0 24
2023 September 11 0 11
2023 August 12 0 12
2023 July 14 0 14
2023 June 12 0 12
2023 May 6 2 8
2023 April 13 8 21
2023 March 0 6 6
2023 February 0 5 5
2023 January 0 8 8
2022 December 0 7 7
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos