Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES – Australia

2016 ◽  
Vol 31 (5) ◽  
pp. 592-604 ◽  
Author(s):  
Hannah Tregea ◽  
Christina Lee ◽  
Jessica L. Browne ◽  
Frans Pouwer ◽  
Jane Speight
2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.


2021 ◽  
Author(s):  
Nadine Misago ◽  
Desire Habonimana ◽  
Ann Alero Roberts ◽  
Patrick Bitangumutwenzi

Abstract Background3502 Congolese refugees based in Bujumbura possess the United Nations Higher Commissioner for Refugees (UNHCR) health insurance covering primary health care needs offered by CMC SOLIS clinic. This study sought to assess the quality of health care services received by Congolese refugees and determine factors affecting satisfaction. MethodsA cross-sectional survey was conducted on 400 refugees visiting CMC SOLIS for health care from June to August 2018. A questionnaire based on SERQUAL tool composed of five health quality dimensions was used to collect data on reliability, tangibility, assurance, responsiveness, and empathy. Logistic models were used to determine factors affecting satisfaction. ResultsOverall, 43% of refugees reported satisfaction with health care services. Age and gender significantly determined overall satisfaction. Other determinants such as education did not have significant effects. ConclusionsOverall, results from this study claim that CMC SOLIS does not offer quality health care services to Congolese refugees living in Bujumbura. Most importantly, the quality of health care services worsened with an increasing age as older ages were associated with less likelihood of satisfaction. Also, health care services offered to females seem to be deficient. Trial registration: N/A


2019 ◽  
Author(s):  
Modupe Rebekah Akinyinka ◽  
Esther Oluwakemi Oluwole ◽  
Olumuyiwa Omotola Odusanya

AbstractBackgroundQuality of health care and client satisfaction are key elements in improving the performance of health systems. A community-based assessment was conducted to determine the level of client satisfaction and the perception of the quality of services received by citizens of Lagos State.MethodologyA descriptive cross-sectional study using both quantitative and qualitative methods, was conducted in four local government areas of Lagos state selected by multi-stage sampling techniques. The survey instruments included an interviewer- administered, pre-tested questionnaire and a 10-itemed focus group discussion guide. The survey obtained information about quality of the facilities and services. The outcome variables were client satisfaction and service quality.ResultsTwo thousand respondents were recruited with a mean age of 37.6±10.21 years. Almost all respondents (98%) rated the health facilities to be clean, 96% felt they received effective treatment from their providers. Six out of ten respondents rated the waiting time to be short and 60% felt that most drugs were available. Eight-five percent opined that the quality of care received was good and 95% were satisfied with the services received. There was a significant correlation between quality of care and client satisfaction (r=0.145, p=0.001). Service factors such as perceived effectiveness of treatment received, confidence in health providers and use of higher level of health care were predictive of client satisfaction and good service quality.ConclusionMost clients were satisfied with health services and felt that service quality was good.


2015 ◽  
pp. 1255 ◽  
Author(s):  
Gudmund Grønhaug ◽  
Jon Hagfors ◽  
Ingebjørg Borch ◽  
Nina Østerås ◽  
Kåre Birger Hagen

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Charlie Reed ◽  
Felicia A. Rabito ◽  
Derek Werthmann ◽  
Shannon Smith ◽  
John C. Carlson

Abstract Background Mobile (MHCs), Community (CHCs), and School-based health clinics (SBHCs) are understudied alternative sources of health care delivery used to provide more accessible primary care to disenfranchised populations. However, providing access does not guarantee utilization. This study explored the utilization of these alternative sources of health care and assessed factors associated with residential segregation that may influence their utilization. Methods A cross-sectional study design assessed the associations between travel distance, perceived quality of care, satisfaction-adjusted distance (SAD) and patient utilization of alternative health care clinics. Adults (n = 165), child caregivers (n = 124), and adult caregivers (n = 7) residing in New Orleans, Louisiana between 2014 and 2015 were conveniently sampled. Data were obtained via face-to face interviews using standardized questionnaires and geospatial data geocoded using GIS mapping tools. Multivariate regression models were used to predict alternative care utilization. Results Overall 49.4% of respondents reported ever using a MCH, CHC, or SBHC. Travel distance was not significantly associated with using either MCH, CHC, or SBHC (OR = 0.91, 0.74–1.11 p > .05). Controlling for covariates, higher perceived quality of care (OR = 1.02, 1.01–1.04 p < .01) and lower SAD (OR = 0.81, 0.73–0.91 p < .01) were significantly associated with utilization. Conclusions Provision of primary care via alternative health clinics may overcome some barriers to care but have yet to be fully integrated as regular sources of care. Perceived quality and mixed-methods measures are useful indicators of access to care. Future health delivery research is needed to understand the multiple mechanisms by which residential segregation influences health-seeking behavior.


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