Healthcare needs and experiences of foreign residents in Japan by language fluency

AbstractObjectivesYoung adults with cerebral palsy (CP) face potential challenges. The transition to young adulthood is characterized by significant changes in roles and responsibilities. Furthermore, young adults with chronic conditions face a transfer from pediatric care to adult healthcare. This study explores how living with CP affects young adults in general, and specifically which psychosocial, medical and healthcare needs are particularly important during this phase of life.MethodsA qualitative study with data from individual, semi-structured, in-depth interviews with six young adults with CP (ages 21–31 years) were transcribed verbatim and analyzed. The participants were selected to provide a maximum variation in age, gender, Gross Motor Function Classification System score and educational background. A descriptive thematic analysis was used to explore patterns and identify themes.ResultsThree themes were identified: “Being a Young Adult”, “Development in Physical Disability and New Challenges in Adulthood” and “Navigating the Healthcare System”. The three themes emerged from 15 sub-themes. Our findings emphasized that young adults with CP faced psychosocial challenges in social relationships, participation in education and work settings and striving towards independence. The transition to young adulthood led to a series of new challenges that the young adults were not prepared for. Medical challenges included managing CP-related physical and cognitive symptoms and navigating adult health care services, where new physicians with insufficient knowledge regarding CP were encountered.ConclusionThe young adults with CP were not prepared for the challenges and changes they faced during their transition into adulthood. They felt that they had been abandoned by the healthcare system and lacked a medical home. Better transitional care is urgently needed to prepare them for the challenges in young adulthood.

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Mapping of Household Surveys to Measure Barriers to Access to Maternal and Child Health Services in India

Journal of Health Management ◽

10.1177/0972063421995026 ◽

2021 ◽

Vol 23 (1) ◽

pp. 10-19

Author(s):

Shivam Gupta ◽

Priyanka Das ◽

Siddhartha Kumar ◽

Arindam Das ◽

P. R. Sodani

Keyword(s):

Child Health ◽

Health Services ◽

Health Survey ◽

Maternal And Child Health ◽

Household Surveys ◽

Access Barriers ◽

Health Service Provision ◽

Healthcare Needs ◽

Unmet Healthcare Needs ◽

And Child Health

Objective: To map the range of access barrier indicators for which data can be derived from the three most common health related household surveys in India. Methods: A mapping review study was conducted to identify access dimensions and indicators of access barriers for maternal and child health (MCH) services included in three household surveys in India: National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS) and Annual Health Survey (AHS). Results: The Tanahashi framework for effective coverage of health services was used in this study, and 12 types of access barriers were identified, from which 23 indicators could be generated. These indicators measure self-reported access barriers for unmet healthcare needs through delayed care, as well as forgone care, and unsatisfactory experiences during health service provision. Multiple barriers could be identified, although there was marked heterogeneity in variables included and how barriers were measured. Conclusions: This study identified tracer indicators that could be used in India to monitor the population that experiences healthcare needs but fails to seek and obtain appropriate healthcare, and determine what the main barriers are. The surveys identified are well validated and allow the disaggregation of these indicators by equity stratifiers. Given the variability of the frequency and methodologies used in these surveys, comparability could be limited.

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Enhancing Patient Centricity and Advancing Innovation in Clinical Research with Virtual Randomized Clinical Trials (vRCTs)

Diagnostics ◽

10.3390/diagnostics11020151 ◽

2021 ◽

Vol 11 (2) ◽

pp. 151

Author(s):

Raphael A. Yaakov ◽

Özgür Güler ◽

Tim Mayhugh ◽

Thomas E. Serena

Keyword(s):

Clinical Trials ◽

Randomized Controlled Trials ◽

Randomized Clinical Trials ◽

Regulatory Compliance ◽

Small Sample ◽

Controlled Trials ◽

Holistic View ◽

Health Crisis ◽

Randomized Controlled ◽

Healthcare Needs

The current public health crisis has highlighted the need to accelerate healthcare innovation. Despite unwavering levels of cooperation among academia, industry, and policy makers, it can still take years to bring a life-saving product to market. There are some obvious limitations, including lack of blinding or masking and small sample size, which render the results less applicable to the real world. Traditional randomized controlled trials (RCTs) are lengthy, expensive, and have a low success rate. There is a growing acknowledgement that the current process no longer fully meets the growing healthcare needs. Advances in technology coupled with proliferation of telehealth modalities, sensors, wearable and connected devices have paved the way for a new paradigm. Virtual randomized controlled trials (vRCTs) have the potential to drastically shorten the clinical trial cycle while maximizing patient-centricity, compliance, and recruitment. This new approach can inform clinical trials in real time and with a holistic view of a patient’s health. This paper provides an overview of virtual clinical trials, addressing critical issues, including regulatory compliance, data security, privacy, and ownership.

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Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

BMC Health Services Research ◽

10.1186/s12913-021-06313-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Solomon Nyame ◽

Edward Adiibokah ◽

Yasmin Mohammed ◽

Victor C. Doku ◽

Caleb Othieno ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Human Rights ◽

Primary Health Care ◽

Service Users ◽

Traditional Health ◽

Healthcare Needs ◽

Primary Health ◽

Traditional Health Practitioners ◽

Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

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Experiences of New Zealand Haemodialysis Patients in Relation to Food and Nutrition Management: A Qualitative Study

Nutrients ◽

10.3390/nu13072299 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2299

Author(s):

Rachael M. McLean ◽

Zhengxiu Xie ◽

Vicky Nelson ◽

Vili Nosa ◽

Hla Thein ◽

...

Keyword(s):

New Zealand ◽

Qualitative Study ◽

Thematic Analysis ◽

Extended Family ◽

Culturally Appropriate ◽

Structured Interviews ◽

Nutrition Management ◽

Healthcare Needs ◽

Food And Nutrition ◽

Major Disruption

People receiving haemodialysis have considerable and complex dietary and healthcare needs, including co-morbidities. A recent New Zealand study has shown that few patients on haemodialysis are able to meet nutritional requirements for haemodialysis. This study aims to describe the perspectives and experiences of dietary management among patients on haemodialysis in New Zealand. This exploratory qualitative study used in-depth semi-structured interviews. Purposive sampling was used to recruit participants from different ethnic groups. Forty interviews were conducted, audio-recorded and transcribed verbatim. An inductive approach was taken using thematic analysis. Forty participants were interviewed. Participants spoke of major disruption to their lives as a result of their chronic kidney disease and being on haemodialysis, including loss of employment, financial challenges, loss of independence, social isolation and increased reliance on extended family. Most had received adequate dietary information, although some felt that more culturally appropriate support would have enabled a healthier diet. These findings show that further support to make the recommended dietary changes while on haemodialysis should focus on socio-cultural factors, in addition to the information already provided.

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Role of caregiver factors in outpatient medical follow-up post-stroke: observational study in Singapore

BMC Family Practice ◽

10.1186/s12875-021-01405-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Shilpa Tyagi ◽

Gerald Choon-Huat Koh ◽

Nan Luo ◽

Kelvin Bryan Tan ◽

Helen Hoenig ◽

...

Keyword(s):

Observational Study ◽

Management Strategies ◽

Stroke Survivor ◽

Stroke Survivors ◽

Post Stroke ◽

Memory Problems ◽

Healthcare Needs ◽

Stroke Study

Abstract Background Outpatient medical follow-up post-stroke is not only crucial for secondary prevention but is also associated with a reduced risk of rehospitalization. However, being voluntary and non-urgent, it is potentially determined by both healthcare needs and the socio-demographic context of stroke survivor-caregiver dyads. Therefore, we aimed to examine the role of caregiver factors in outpatient medical follow-up (primary care (PC) and specialist outpatient care (SOC)) post-stroke. Method Stroke survivors and caregivers from the Singapore Stroke Study, a prospective, yearlong, observational study, contributed to the study sample. Participants were interviewed 3-monthly for data collection. Counts of PC and SOC visits were extracted from the National Claims Database. Poisson modelling was used to explore the association of caregiver (and patient) factors with PC/SOC visits over 0–3 months (early) and 4–12 months (late) post-stroke. Results For the current analysis, 256 stroke survivors and caregivers were included. While caregiver-reported memory problems of a stroke survivor (IRR: 0.954; 95% CI: 0.919, 0.990) and caregiver burden (IRR: 0.976; 95% CI: 0.959, 0.993) were significantly associated with lower early post-stroke PC visits, co-residing caregiver (IRR: 1.576; 95% CI: 1.040, 2.389) and negative care management strategies (IRR: 1.033; 95% CI: 1.005, 1.061) were significantly associated with higher late post-stroke SOC visits. Conclusion We demonstrated that the association of caregiver factors with outpatient medical follow-up varied by the type of service (i.e., PC versus SOC) and temporally. Our results support family-centred care provision by family physicians viewing caregivers not only as facilitators of care in the community but also as active members of the care team and as clients requiring care and regular assessments.

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