scholarly journals A Qualitative Study to Explore the Experiences of Older People Utilising Outpatient Healthcare Services from a Teaching Hospital in Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Peter Adatara ◽  
Philemon Adoliwine Amooba

Background. Empirical evidence suggests that when older people are provided with quality and affordable healthcare services, their health status can be improved. However, in low- and middle-income countries, healthcare services may not be fully resourced, leading to difficulties for older people utilising those services. There is a paucity of research studies regarding the experiences of older persons accessing healthcare services in sub-Saharan Africa including Ghana. Aim. The purpose of this study was to explore and describe the experiences of older people utilising outpatient healthcare services from a Teaching hospital in Ghana. Methods. This study adopted a descriptive qualitative approach to describe the experiences of older persons utilising outpatient healthcare services. Participants included a total of twelve older people between the ages of 60 and 80 years who utilised outpatient healthcare services at the hospital. A semistructured interview guide was used to conduct interviews with participants, and their views were analysed into descriptive themes. Results. The results in this study showed that the participants experienced the following in utilising outpatient healthcare services: long waiting hours in accessing outpatient healthcare, poor attitudes from health staff, lack of drugs from the healthcare facility, inadequate information from health staff in the healthcare facility, lack of specialist care at the healthcare facility, and high confidence and trust in the efficacy of the orthodox healthcare. Conclusion. The findings from this qualitative study demonstrated that the participants encountered some challenges in accessing outpatient healthcare services. There is the need for government and other stakeholders to address the challenges encountered by older people in accessing healthcare in order to facilitate the utilisation of healthcare among older persons for better health outcomes.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 420-421
Author(s):  
Andrew Banda ◽  
Norah Keating ◽  
Jaco Hoffman ◽  
Jose Parodi ◽  
Nereide Curreri

Abstract In their recent volume, Critical Rural Gerontology, Skinner et al (2021) challenge us to set aside unidimensional notions of rural communities as bypassed vs very supportive; and to identify the elements of rurality that empower or exclude older people and how these differ across cultures and settings. Covid-19 has highlighted the need for safe and inclusive communities. Given that LMIC will be home to the majority of older adults (Gonzales et al. 2015), we undertook a scoping review of features of rural communities that influence wellbeing of older people in countries across Latin America and Sub-Saharan Africa. The review included literature in English, French, Spanish and Portuguese, using search engines MEDLINE, CINAHL Complete, PsycInfo, SocINDEX, SciELO, AJOL (Africa Journals Online), LILACS, Redalyc, LatinIndex and Clacso. Findings illustrate diversity in how community features including remoteness, infrastructure and belonging influence material, social and subjective wellbeing of older residents.


2020 ◽  
Vol 5 (4) ◽  
pp. e001901
Author(s):  
Rachel King ◽  
Zubayiri Sebyala ◽  
Moses Ogwal ◽  
George Aluzimbi ◽  
Rose Apondi ◽  
...  

In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.


2011 ◽  
Vol 1 (1) ◽  
pp. 3 ◽  
Author(s):  
Guri Bitnes Wiik ◽  
Siri Devik ◽  
Ove Hellzen

The majority of older people wish to continue to live at home for as long as possible. As a consequence, the healthcare system, including cancer care, is located in urban areas and people living in rural areas must commute to gain access to the services offered. The aim of this study was to investigate how older people, who live on their own, experience living with incurable cancer and commuting for palliative care in rural Norway. A case study was designed and informants were recruited not because they were typical but because they were deemed to have the potential to contribute to knowledge about the phenomenon of being an older person who has been diagnosed with incurable cancer and lives alone in a rural area. Three major categories were identified: &ldquo;<em>Hovering between hope and fear</em>, <em>Stressful commuting to palliative care</em>, and <em>Being exhausted</em>. The findings indicated that older people who have been stricken with incurable cancer and who live alone in rural areas have to<em> walk the palliative path alone</em>. A common feature of all the informants is that they do not speak out and they do not complain. Even though the trend in healthcare is towards centralized treatment, shorter and more effective stays in hospital, and policlinic (policlinic services are a place where healthcare services can be accessed without the need for an overnight stay in hospital, usually such clinics are located close to a hospital) treatment and care, not all older persons manage to take care of themselves. The findings suggest that nurses should pay more attention to these patients&rsquo; needs for care at different levels of the healthcare service.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Joseph Amani ◽  
Anna-Karin Hurtig ◽  
Gasto Frumence ◽  
Angwara Denis Kiwara ◽  
Isabel Goicolea ◽  
...  

Abstract Background Health insurance (HI) has increasingly been accepted as a mechanism to facilitate access to healthcare in low and middle-income countries. However, health insurance members, especially those in Sub-Saharan Africa, have reported a low responsiveness in health systems. This study aimed to explore the experiences and perceptions of healthcare services from the perspective of insured and uninsured elderly in rural Tanzania. Method An explanatory qualitative study was conducted in the rural districts of Igunga and Nzega, located in western-central Tanzania. Eight focus group discussions were carried out with 78 insured and uninsured elderly men and women who were purposely selected because they were 60 years of age or older and had utilised healthcare services in the past 12 months prior to the study. The interview questions were inspired by the domains of health systems’ responsiveness. Qualitative content analysis was used to analyse the data. Results Elderly participants appreciated that HI had facilitated the access to healthcare and protected them from certain costs. But they also complained that HI had failed to provide equitable access due to limited service benefits and restricted use of services within schemes. Although elderly perspectives varied widely across the domains of responsiveness, insured individuals generally expressed dissatisfaction with their healthcare. Conclusions The national health insurance policy should be revisited in order to improve its implementation and expand the scope of service coverage. Strategic decisions are required to improve the healthcare infrastructure, increase the number of healthcare workers, ensure the availability of medicines and testing facilities at healthcare centers, and reduce long administrative procedures related to HI. A continuous training plan for healthcare workers focused on patients´ communication skills and care rights is highly recommended.


2017 ◽  
Vol 16 (5) ◽  
pp. 566-579 ◽  
Author(s):  
E. Grace Lewis ◽  
Lloyd L. Oates ◽  
Jane Rogathi ◽  
Ashanti Duinmaijer ◽  
Aisa Shayo ◽  
...  

ABSTRACTObjective:Little is known about the current views and practices of healthcare professionals (HCPs) in Sub-Saharan Africa (SSA) regarding delivery of hospital palliative care. The present qualitative study explored the views of nursing staff and medical professionals on providing palliative and end-of-life care (EoLC) to hospital inpatients in Tanzania.Method:Focus group discussions were conducted with a purposive sample of HCPs working on the medical and pediatric wards of the Kilimanjaro Christian Medical Centre, a tertiary referral hospital in northern Tanzania. Transcriptions were coded using a thematic approach.Results:In total, 32 healthcare workers were interviewed via 7 focus group discussions and 1 semistructured interview. Four major themes were identified. First, HCPs held strong views on what factors were important to enable individuals with a life-limiting diagnosis to live and die well. Arriving at a state of “acceptance” was the ultimate goal; however, they acknowledged that they often fell short of achieving this for inpatients. Thus, the second theme involved identifying the “barriers” to delivering palliative care in hospital. Another important factor identified was difficulty with complex communications, particularly “breaking bad news,” the third theme. Fourth, participants were divided about their personal preferences for “place of EoLC,” but all emphasized the benefits of the hospital setting so as to enable better symptom control.Significance of results:Despite the fact that all the HCPs interviewed were regularly involved in providing palliative and EoLC, they had received limited formal training in its provision, although they identified such training as a universal requirement. This training gap is likely to be present across much of SSA. Palliative care training, particularly in terms of communication skills, should be comprehensively integrated within undergraduate and postgraduate education. Research is needed to develop culturally appropriate curricula to equip HCPs to manage the complex communication challenges that occur in caring for a diverse inpatient group with palliative care needs.


2021 ◽  
Vol 57 (3) ◽  
Author(s):  
Andrea Visagie ◽  
Annaline Keet

The world’s population is ageing and older people may be exposed to traumatic experiences during their lifetime. Symptoms are often regarded as part of the ageing process and not treated as trauma. Little is known about eye movement integration (EMI) as intervention for symptoms of trauma in older people. This article reports on older people’s experience of EMI as an intervention for their symptoms of trauma. The qualitative study employed an exploratory-descriptive research design with a purposive sampling method. Participants considered EMI as positive and beneficial. Suggestions are made to improve EMI when working with older people.


Author(s):  
Astrid Fjell ◽  
Kristin Ådnøy Eriksen ◽  
Monica Hermann ◽  
Anne-Marie Boström ◽  
Seiger Berit Cronfalk

Abstract Aim: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support. Background: The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons. Method: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis. Findings: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.


Author(s):  
Helene Seaward ◽  
Tenzin Wangmo ◽  
Monika Egli-Alge ◽  
Lutz-Peter Hiersemenzel ◽  
Marc Graf ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared


Sign in / Sign up

Export Citation Format

Share Document