Development and Validation of the Barriers to Care Scale: Assessing Access to Care among Canadian Armed Forces Health Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

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Negotiating candidacy: ethnic minority seniors' access to care

Ageing and Society ◽

10.1017/s0144686x08007952 ◽

2009 ◽

Vol 29 (4) ◽

pp. 585-608 ◽

Cited By ~ 49

Author(s):

SHARON KOEHN

Keyword(s):

Health Care ◽

Access To Care ◽

Ethnic Minority ◽

Health Care Providers ◽

Service Providers ◽

Future Research ◽

Care Providers ◽

Optimal Care ◽

Barriers To Access ◽

Recommendations For Action

ABSTRACTThe ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

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Evaluating usability, effectiveness, and usage of telehealth technologies

10.32469/10355/48176 ◽

2014 ◽

Author(s):

◽

Mirna Becevic

Keyword(s):

Health Care ◽

Access To Care ◽

Health Care Providers ◽

New Technologies ◽

Care Delivery ◽

Traditional Approach ◽

Additional Stress ◽

Care Providers ◽

Medical Specialties ◽

Number Of Patients

Affordable Care Act (ACA) has allowed more patients that did not previously have health care insurance to have coverage and access to care. This increase in the number of patients seeking medical care will only add additional stress to the existing disproportion of supply and demand for health care providers. In addition, rising health care costs have major effect on how, where, and even if consumers will get needed care. This study examined three different telehealth platforms in three different medical specialties in order to evaluate the perception that they would be appropriate vehicles for increasing access to care. I also wanted to find out what the users' perceptions of these technologies are, as that can be a driving factor in adoption of new technologies. The first study examined the usability and acceptance of new mobile application in teledermatology clinic. The second study focused on usability and acceptance of ICU Robots in a medical ICU. Finally, the third study evaluated if children and youth currently using telepsychiatry as a care delivery method would have other in-person options if telehealth was not available. The results of these three studies point at the complexity and richness of telehealth. The adoption and acceptance of mHealth was very fast and streamlined. In the same fashion, children might not have other appropriate options for care if telepsychiatry was not available in rural Missouri. Interestingly, though, the provider acceptance of ICU Robots was slow, with some provider disengagements observed. This research contributes to the field of health informatics and medical informatics by evaluating adoption and usability of technologies from the provider perspective, vs. the more traditional approach of examining patient satisfaction, or even provider satisfaction without fully understanding the implications of attitudes on the adoption itself. This study has focused purposefully on different groups of providers using different types of telehealth technologies so we could try to see the bigger picture of how telehealth actually contributes to the health care organizational structure.

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Attitudes Toward HIV Health Care Providers Scale: Development and Validation

AIDS Patient Care and STDs ◽

10.1089/apc.2004.18.714 ◽

2004 ◽

Vol 18 (12) ◽

pp. 714-720 ◽

Cited By ~ 24

Author(s):

Jamie S. Bodenlos ◽

Karen B. Grothe ◽

Katie Kendra ◽

Dori Whitehead ◽

Amy L. Copeland ◽

...

Keyword(s):

Health Care ◽

Scale Development ◽

Health Care Providers ◽

Care Providers ◽

Scale Development And Validation ◽

Development And Validation

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iCanCope with Pain™: User-Centred Design of a Web- and Mobile-Based Self-Management Program for Youth with Chronic Pain Based on Identified Health Care Needs

Pain Research and Management ◽

10.1155/2014/935278 ◽

2014 ◽

Vol 19 (5) ◽

pp. 257-265 ◽

Cited By ~ 63

Author(s):

Jennifer N Stinson ◽

Chitra Lalloo ◽

Lauren Harris ◽

Lisa Isaac ◽

Fiona Campbell ◽

...

Keyword(s):

Social Support ◽

Health Care ◽

Chronic Pain ◽

Pain Management ◽

Health Care Providers ◽

Barriers To Care ◽

Management Strategies ◽

Management Program ◽

Self Management ◽

Care Providers

BACKGROUND: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain.OBJECTIVES: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™.METHODS: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario. Interdisciplinary health care providers were also recruited from these sites. Three focus groups were conducted with adolescents (n=16) and one with pediatric health care providers (n=7). Individual adolescent interviews were also conducted (n=7).RESULTS: Qualitative analysis uncovered four major themes: pain impact; barriers to care; pain management strategies; and transition to adult care. Pain impacted social, emotional, physical and role functioning, as well as future goals. Barriers to care were revealed at the health care system, patient and societal levels. Pain management strategies included support systems, and pharmacological, physical and psychological approaches. Transition subthemes were: disconnect between pediatric and adult systems; skills development; parental role; and fear/anxiety. Based on these identified needs, the iCanCope with Pain™ architecture will include the core theory-based functionalities of: symptom self-monitoring; personalized goal setting; pain coping skills training; peer-based social support; and chronic pain education.CONCLUSIONS: The proposed iCanCope with Pain™ program aims to address the self-management needs of adolescents with chronic pain by improving access to disease information, strategies to manage symptoms and social support.

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Barriers to Care: The Challenges for Canadian Refugees and their Health Care Providers

Journal of Refugee Studies ◽

10.1093/jrs/feq038 ◽

2010 ◽

Vol 23 (4) ◽

pp. 523-545 ◽

Cited By ~ 101

Author(s):

M. McKeary ◽

B. Newbold

Keyword(s):

Health Care ◽

Health Care Providers ◽

Barriers To Care ◽

Care Providers

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Isolated Cervical Dystonia: Management and Barriers to Care

Frontiers in Neurology ◽

10.3389/fneur.2020.591418 ◽

2020 ◽

Vol 11 ◽

Author(s):

Melanie Leigh Supnet ◽

Patrick Acuna ◽

Samuel J. Carr ◽

Jan Kristoper de Guzman ◽

Xena Al Qahtani ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Health Care Providers ◽

Cervical Dystonia ◽

Barriers To Care ◽

Age Of Onset ◽

Care Providers ◽

Sf 36 ◽

Time To Diagnosis

Background: Cervical dystonia (CD) is a rare disorder, and health care providers might be unfamiliar with its presentation, thus leading to delay in the initial diagnosis. The lack of awareness displays the need to highlight the clinical features and treatment in cervical dystonia. In our cohort, we have identified an earlier age of onset in men, despite an overall preponderance of affected women.Objective: We aim to identify the prevalence, age of onset, spread, and treatment modalities of CD in the population. We also highlight the barriers which patients encounter related to diagnosis, follow-up, and treatment.Methods: We reviewed 149 CD patients who attended specialized Dystonia Clinics over a 14-year period. Dystonia severity was rated using the Burke-Fahn-Marsden (BFM), Tsui, and Toronto Western Spasmodic Torticollis Rating Scales (TWSTRS). Mood and quality of life were assessed using Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and 36-Item Short Form Health Survey (SF-36).Results: CD patients were majority White (91.3%) and more commonly female (75.8%). Men had an earlier median age of onset, 40.5 years (p = 0.044). BAI revealed a mean score of 7.2 (±6.4, n = 50) indicating minimal anxiety while BDI revealed a mean score of 7.30 (±7.6, n = 50) indicating minimal depression. The only SF-36 subscales associated with CD severity were physical functioning (p = 0.040) pain (p = 0.008) and general health (p = 0.014).Conclusion: There appear to be gender differences in both the prevalence and age of onset of the disease. There was a 3-fold higher incidence in women than in men. CD patients of both sexes experience barriers to care, which can be reflected in their quality of life and time-to-diagnosis. In addition, males were less likely to experience an objective benefit with botulinum toxin treatment and more likely to discontinue care. Greater awareness of CD by health care providers is important to reduce the time-to-diagnosis.

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The Health Care Sector Response to Intimate Partner Violence in Kenya: Exploring Health Care Providers’ Perceptions of Care for Victims

Violence and Victims ◽

10.1891/0886-6708.vv-d-13-00146 ◽

2016 ◽

Vol 31 (5) ◽

pp. 888-900

Author(s):

Quynh-Uyen P. Nguyen ◽

Neil Flynn ◽

Morris Kitua ◽

Esther M. Muthumbi ◽

Daniel M. Mutonga ◽

...

Keyword(s):

Health Care ◽

Intimate Partner Violence ◽

Physical Abuse ◽

Health Care Providers ◽

Partner Violence ◽

Barriers To Care ◽

Intimate Partner ◽

Care Providers ◽

Care Guidelines

Intimate partner violence (IPV) is prevalent in Kenya, yet few studies have examined the role of health care providers (HCPs) in addressing IPV. Interviews with 18 Kenyan HCPs explored how they recognize and support IPV victims, including barriers to care. HCPs most commonly see victims of physical abuse. Medical responses to victims included counseling, treatment, and referrals, although rural HCPs reported fewer available services than in urban settings. HCPs attributed the limited response to IPV victims to unclear laws and fragmented care, especially in a culture where IPV remains largely unspoken and underreported. These results underscore the need for increased training on IPV assessment and response for HCPs in Kenya, with emphasis on standardized care guidelines for victims.

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