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[Access to health care: perceptions of patients with multiple chronic conditions].

https://arctichealth.org/en/permalink/ahliterature167791
Source
Can Fam Physician. 2005 Nov;51:1502-3
Publication Type
Article
Date
Nov-2005
Author
Martin Fortin
Danielle Maltais
Catherine Hudon
Lise Lapointe
Antoine Lutumba Ntetu
Author Affiliation
Département de Médecine de Famille, l'Université de Sherbrooke.
Source
Can Fam Physician. 2005 Nov;51:1502-3
Date
Nov-2005
Language
French
Publication Type
Article
Keywords
Appointments and Schedules
Chronic Disease
Communication Barriers
Female
Health Care Surveys - statistics & numerical data
Health Services Accessibility - statistics & numerical data
Humans
Male
Physician-Patient Relations
Physicians
Quebec
Referral and Consultation - statistics & numerical data
Telephone
Waiting Lists
Abstract
To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access.
Qualitative study with focus groups.
Family practice unit in Chicoutimi (Saguenay), Que.
Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions.
For this pilot study, only three focus group discussions were held.
The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access.
Systematic callbacks, family physicians' personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions.
Notes
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PubMed ID
16926944 View in PubMed
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Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
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PubMed ID
21915240 View in PubMed
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Acculturation and cancer information preferences of Spanish-speaking immigrant women to Canada: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature147531
Source
Health Care Women Int. 2009 Dec;30(12):1131-51
Publication Type
Article
Date
Dec-2009
Author
Maria D Thomson
Laurie Hoffman-Goetz
Author Affiliation
Faculty of Applied Health Sciences, Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada.
Source
Health Care Women Int. 2009 Dec;30(12):1131-51
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Acculturation
Adult
Communication Barriers
Cultural Characteristics
Emigrants and Immigrants - psychology
Female
Health Behavior - ethnology
Health Knowledge, Attitudes, Practice
Hispanic Americans - psychology
Humans
Middle Aged
Neoplasms - ethnology - prevention & control - psychology
Ontario
Patient Acceptance of Health Care - ethnology
Questionnaires
Social Change
Socioeconomic Factors
Women's Health - ethnology
Young Adult
Abstract
To explore the cancer information preferences of immigrant women by their level of acculturation we conducted interviews with 34 Spanish-speaking English-as-a-second-language (ESL) women. Chi-square and Fisher's exact tests were used to look for differences by acculturation. Four themes were identified: What is prevention? What should I do; sources of my cancer information, strategies I use to better understand, and identifying and closing my health knowledge gaps. Acculturation did not differentiate immigrant women's cancer information sources, preferences, or strategies used to address language barriers. We suggest the effect of acculturation is neither direct nor simple and may reflect other factors including self-efficacy.
PubMed ID
19894155 View in PubMed
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Achieving high acceptability of HIV testing in a population-based survey among immigrants in Finland.

https://arctichealth.org/en/permalink/ahliterature265149
Source
Scand J Public Health. 2015 Jun;43(4):393-8
Publication Type
Article
Date
Jun-2015
Author
Paula J Tiittala
Pia S Kivelä
Matti A Ristola
Heljä-Marja Surcel
Päivikki M S Koponen
Mulki Mölsä
Jukka Ollgren
Kirsi Liitsola
Source
Scand J Public Health. 2015 Jun;43(4):393-8
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Communication Barriers
Counseling - statistics & numerical data
Emigrants and Immigrants - psychology - statistics & numerical data
Employment - statistics & numerical data
Female
Finland
HIV Infections - diagnosis
Humans
Language
Male
Mass Screening - utilization
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Risk factors
Abstract
The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance.
The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study.
Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV.
The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys.
PubMed ID
25788469 View in PubMed
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Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study.

https://arctichealth.org/en/permalink/ahliterature257359
Source
Int J Equity Health. 2014;13:49
Publication Type
Article
Date
2014
Author
Emina Hadziabdic
Katarina Hjelm
Author Affiliation
Department of Health and Caring Sciences, Faculty of Health and Life Sciences Linnaeus University, Växjö, SE-351 95, Sweden. emina.hadziabdic@lnu.se.
Source
Int J Equity Health. 2014;13:49
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Arabs
Attitude
Communication
Communication Barriers
Cultural Competency
Delivery of Health Care - ethnology
Female
Focus Groups
Humans
Language
Male
Middle Aged
Qualitative Research
Sweden
Transients and Migrants
Translating
Young Adult
Abstract
Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area.
A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.
Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speaking participants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment.
The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.
Notes
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PubMed ID
24934755 View in PubMed
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Are there mental health differences between francophone and non-francophone populations in manitoba?

https://arctichealth.org/en/permalink/ahliterature256463
Source
Can J Psychiatry. 2014 Jul;59(7):366-75
Publication Type
Article
Date
Jul-2014
Author
Mariette Jeanne Chartier
Gregory Finlayson
Heather Prior
Kari-Lynne Mcgowan
Hui Chen
Randy Walld
Janelle De Rocquigny
Author Affiliation
Research Scientist, Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba; Assistant Professor, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba.
Source
Can J Psychiatry. 2014 Jul;59(7):366-75
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adult
Communication Barriers
Cross-Cultural Comparison
Cross-Sectional Studies
Cultural Characteristics
Female
Health Surveys
Hierarchy, Social
Humans
Language
Life Style
Male
Manitoba
Mental Disorders - diagnosis - epidemiology - psychology
Middle Aged
Substance-Related Disorders - diagnosis - epidemiology - psychology
Suicide - statistics & numerical data
Suicide, Attempted - statistics & numerical data
Abstract
Francophones may experience poorer health due to social status, cultural differences in lifestyle and attitudes, and language barriers to health care. Our study sought to compare mental health indicators between Francophones and non-Francophones living in the province of Manitoba.
Two populations were used: one from administrative datasets housed at the Manitoba Centre for Health Policy and the other from representative survey samples. The administrative datasets contained data from physician billings, hospitalizations, prescription drug use, education, and social services use, and surveys included indicators on language variables and on self-rated health.
Outside urban areas, Francophones had lower rates of diagnosed substance use disorder (rate ratio [RR] = 0.80; 95% CI 0.68 to 0.95) and of suicide and suicide attempts (RR = 0.59; 95% CI 0.43 to 0.79), compared with non-Francophones, but no differences were found between the groups across the province in rates of diagnosed mood disorders, anxiety disorders, dementia, or any mental disorders after adjusting for age, sex, and geographic area. When surveyed, Francophones were less likely than non-Francophones to report that their mental health was excellent, very good, or good (66.9%, compared with 74.2%).
The discrepancy in how Francophones view their mental health and their rates of diagnosed mental disorders may be related to health seeking behaviours in the Francophone population. Community and government agencies should try to improve the mental health of this population through mental health promotion and by addressing language and cultural barriers to health services.
PubMed ID
25007420 View in PubMed
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Arranging and negotiating the use of informal interpreters in general practice consultations: experiences of refugees and asylum seekers in the west of Ireland.

https://arctichealth.org/en/permalink/ahliterature150233
Source
Soc Sci Med. 2009 Jul;69(2):210-4
Publication Type
Article
Date
Jul-2009
Author
Anne MacFarlane
Zhanna Dzebisova
Dmitri Karapish
Bosiljka Kovacevic
Florence Ogbebor
Ekaterina Okonkwo
Author Affiliation
National University of Ireland, Galway, Ireland. anne.macfarlane@nuigalway.ie
Source
Soc Sci Med. 2009 Jul;69(2):210-4
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Communication Barriers
Family Practice
Female
Health Services Accessibility
Humans
Interviews as Topic
Ireland
Male
Multilingualism
Physician-Patient Relations
Refugees
Russia - ethnology
Serbia - ethnology
Social Support
Abstract
This paper focuses on the work involved for service users in arranging and negotiating the use of informal interpreters from their social networks for general practice consultations. The data are drawn from a participatory learning and action research study, carried out in the west of Ireland. Qualitative data were gathered using a peer researcher model from a 'hard to reach' community of Serbo-Croat and Russian refugees and asylum seekers (n=26). The findings elucidate that there is a tension for service users between the experienced benefits of having a trusted friend/family member present to act as their interpreter and the burden of work and responsibility to manage the language barrier. Participants emphasize that, for them, the use of informal interpreters can be inadequate and problematic and can leave them worried, frustrated and with experiences of error and misdiagnosis. Overall, they state a clear preference for the use of professional, trained interpreters in general practice consultations which is currently unavailable to them in routine Irish general practice consultations.
PubMed ID
19535192 View in PubMed
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Assessment of communication barriers in community pharmacies.

https://arctichealth.org/en/permalink/ahliterature182710
Source
Eval Health Prof. 2003 Dec;26(4):380-403
Publication Type
Article
Date
Dec-2003
Author
Elan C Paluck
Lawrence W Green
C James Frankish
David W Fielding
Beth Haverkamp
Author Affiliation
Regina Qu'Appelle Health Region, Saskatchewan, Canada.
Source
Eval Health Prof. 2003 Dec;26(4):380-403
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
British Columbia
Communication Barriers
Community Pharmacy Services - standards - statistics & numerical data - utilization
Drug Prescriptions
Female
Humans
Male
Middle Aged
Pharmacists - standards - statistics & numerical data
Pharmacy Administration
Professional-Patient Relations
Prospective Studies
Questionnaires
Regression Analysis
Reproducibility of Results
Verbal Behavior
Abstract
This study identified previously reported facilitators and barriers to pharmacist-client communication and then evaluated their impact on the observed communication behaviors of pharmacists. Pharmacists (n = 100) completed a seven-page questionnaire collecting information on 11 variables that had been organized according to the Policy, Regulatory and Organizational Constructs in Educational and Ecological Development (PROCEDE) model as predisposing, enabling, or reinforcing of pharmacist communication with their clients. Demographic variables also were included. "Communication quality" served as the study's dependent variable, whereas pharmacist responses served as the independent variables. Communication quality scores for each pharmacist were obtained from the analysis of 765 audiorecordings of verbal exchanges occurring between the study pharmacists and their consenting clients during 4-hour, on-site observation periods. Four of the variables examined in the study were found to share a unique relationship with communication quality (pharmacists' attitude, year of graduation, adherence expectations, and outcome expectations). Hierarchical multiple regression analysis revealed that the variables measured in the questionnaire accounted for 23% of the variance in communication quality scores. Plausible explanations for why the study was unable to capture more of the variance in its proposed relationships and future areas for research are provided.
PubMed ID
14631610 View in PubMed
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Barriers against psychosocial communication: oncologists' perceptions.

https://arctichealth.org/en/permalink/ahliterature107184
Source
J Clin Oncol. 2013 Oct 20;31(30):3815-22
Publication Type
Article
Date
Oct-20-2013
Author
Hanna Fagerlind
Åsa Kettis
Bengt Glimelius
Lena Ring
Author Affiliation
All authors: Uppsala University; Lena Ring, Medical Products Agency, Uppsala; Bengt Glimelius, Karolinska Institutet, Stockholm, Sweden.
Source
J Clin Oncol. 2013 Oct 20;31(30):3815-22
Date
Oct-20-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety - etiology
Attitude of Health Personnel
Communication Barriers
Depression - etiology
Female
Humans
Male
Medical Oncology - manpower
Middle Aged
Neoplasms - psychology
Physician's Practice Patterns - standards - statistics & numerical data - trends
Physician-Patient Relations
Physicians - psychology
Questionnaires
Social Perception
Social Support
Stress, Psychological - etiology
Sweden
Time Factors
Abstract
To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication.
A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers.
Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P
PubMed ID
24043746 View in PubMed
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Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

https://arctichealth.org/en/permalink/ahliterature280008
Source
J Clin Nurs. 2016 Oct;25(19-20):2786-97
Publication Type
Article
Date
Oct-2016
Author
Jeanette W Kirk
Ditte M Sivertsen
Janne Petersen
Per Nilsen
Helle V Petersen
Source
J Clin Nurs. 2016 Oct;25(19-20):2786-97
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Aged
Communication Barriers
Denmark
Emergencies - nursing
Emergency Service, Hospital
Evidence-Based Medicine
Female
Focus Groups
Geriatric Assessment
Health Services for the Aged
Humans
Interviews as Topic
Male
Models, Theoretical
Nursing Assessment
Severity of Illness Index
Abstract
The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team.
A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed.
Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers.
The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described.
Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation.
Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived.
The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned.
PubMed ID
27273150 View in PubMed
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196 records – page 1 of 20.