scholarly journals “Things Are Different Now But”: Older LGBT Adults’ Experiences and Unmet Needs in Health Care

2019 ◽  
Vol 31 (5) ◽  
pp. 492-501 ◽  
Author(s):  
Candace W. Burton ◽  
Jung-Ah Lee ◽  
Anders Waalen ◽  
Lisa M. Gibbs
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Unmet Needs ◽  
Care Providers ◽  
Medical Providers ◽  
Negative Experiences ◽  
Semistructured Interviews ◽  
Lgbt Community ◽  
Bisexual And Transgender

Background: Approximately 2.7 million U.S. older adults self-identify as lesbian, gay, bisexual, and transgender (LGBT). Many felt unsafe revealing their sexual orientation until relatively recently, and may still not be “out” to medical providers. The aim of this study was to increase understanding of the experiences and needs of older LGBT adults when accessing care. Method: Individual semistructured interviews were conducted with 10 individuals aged 65 years or older from a local LGBT community. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed via thematic analysis. Results: Major themes were “Outness,” “Things are Different Now,” and “Additional Resources.” These describe participant comfort with being “out”; how treatment they received changed over time, and needed services or other options from the community. Conclusion: While many older LGBT adults are accustomed to navigating social mores to avoid negative experiences, nurses as well as other health care providers must be prepared to create trusting relationships with these individuals to provide truly comprehensive care.

scholarly journals A Thematic Analysis of Stigma and Disclosure for Perinatal Depression on an Online Forum

2016 ◽  
Vol 3 (2) ◽  
pp. e18 ◽  
Author(s):  
Donna Moore ◽  
Susan Ayers ◽  
Nicholas Drey
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Care Provider ◽  
Care Providers ◽  
Online Forums ◽  
Negative Experiences ◽  
Treatment Uptake ◽  
Professional Treatment

Background Perinatal mental illness is a global health concern; however, many women do not get the treatment they need to recover. Some women choose not to seek professional help and get no treatment because they feel stigmatized. Online forums for various health conditions, including perinatal mental health, can be beneficial for members. Little is known about the role that online forums for perinatal mental illness play in reducing stigma and subsequent disclosure of symptoms to health care providers and treatment uptake. Objective This study aimed to examine stigma and disclosure in forums and describe any potential disadvantages of forum use. Methods An online forum for mothers was examined and 1546 messages extracted from 102 threads from the antenatal and postnatal depression section. These messages were subjected to deductive systematic thematic analysis to identify common themes regarding stigma and disclosure of symptoms and potential disadvantages of forum use. Results Two major themes were identified: stigma and negative experiences of disclosure. Stigma had 3 subthemes: internal stigma, external stigma, and treatment stigma. Many women were concerned about feeling like a “bad” or “failed” mother and worried that if they disclosed their symptoms to a health care provider they would be stigmatized. Posts in response to this frequently encouraged women to disclose their symptoms to health care providers and accept professional treatment. Forum discourse reconstructed the ideology of motherhood as compatible with perinatal mental illness, especially if the woman sought help and adhered to treatment. Many women overcame stigma and replied that they had taken advice and disclosed to a health care provider and/or taken treatment. Conclusions Forum use may increase women's disclosure to health care providers by challenging their internal and external stigma and this may strengthen professional treatment uptake and adherence. However, a few posts described negative experiences when disclosing to health care providers.

scholarly journals Determining the unmet needs of patients with intracranial meningioma—a qualitative assessment

2019 ◽  
Author(s):  
Ami Baba ◽  
Melissa D McCradden ◽  
Jessica Rabski ◽  
Michael D Cusimano
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Patient Population ◽  
Unmet Needs ◽  
Postoperative Recovery ◽  
Qualitative Assessment ◽  
Postoperative Phase ◽  
Care Providers ◽  
Supportive Needs

Abstract Background Meningiomas are the most common primary benign brain neoplasms, but despite their commonality, the supportive needs of this patient population have been overlooked. The aim of this study is to identify unmet needs of meningioma patients, caregivers, and health care providers. Methods We adopted a patient-centered approach by using qualitative interviewing with patients diagnosed with a meningioma who have undergone treatment in the last 10 years since the date of their interview. Informal caregivers (family and/or friends) of the patient population and health care providers who are normally involved in the management and care of meningioma patients were also interviewed. Interview transcripts were subjected to thematic analysis. Results Of the 50 participants interviewed, there were 30 patients, 12 caregivers, and 8 health care professionals. Thematic analysis revealed 4 overarching themes: (1) access to targeted postoperative care, (2) financial struggles for patients and their families, (3) lack of information specific to meningiomas and postsurgical management, and (4) lack of psychosocial support. Conclusion This study identified supportive needs specific to the meningioma patient population, which predominantly falls within the postoperative phase. The postoperative journey of this patient population could potentially extend to the rest of the patient’s life, which necessitates resources and information directed to support postoperative recovery and management. The development of directly relevant supportive resources that support meningioma patients in their postoperative recovery is necessary to improve the health-related quality of life in this patient population.

Health Care Providers’ Readiness to Identify and Respond to Intimate Partner Violence

2019 ◽  
pp. 088626051986770 ◽  
Author(s):  
Lynette M. Renner ◽  
Qi Wang ◽  
Mary E. Logeais ◽  
Cari Jo Clark
Keyword(s):  
Health Care ◽  
Intimate Partner Violence ◽  
Behavioral Health ◽  
Health Care Providers ◽  
Nursing Staff ◽  
Partner Violence ◽  
Intimate Partner ◽  
Health Providers ◽  
Care Providers ◽  
Medical Providers

Screening rates for intimate partner violence (IPV) among most health care providers are low; yet, positive interactions with providers can benefit people who experience IPV, with respect to increased safety, support, and self-efficacy. Missing is a broad assessment and comparison of knowledge, attitudes, and behavior across the range of providers who are likely to be involved in a response to IPV disclosure. The purpose of our study was to assess health care providers’ IPV preparation, knowledge, opinions, and practices and examine differences across three types of health care providers (medical providers, nursing staff, and social/behavioral health providers). We used an anonymous online survey to gather self-reported information on preparation, knowledge, opinions, and practices around IPV. A random sample of 402 providers was drawn from 13 clinics in a large multispecialty outpatient practice setting. The respondents ( N = 204) consisted of medical providers ( n = 70), nursing staff ( n = 107), and social/behavioral health providers ( n = 27). Data analyses consisted of univariate, bivariate, and multivariate analyses. Social/behavioral health providers reported more preparation, knowledge, victim understanding, and less job-related constraints, yet they reported lower screening rates than medical providers and nursing staff. Overall, no provider group seemed well-equipped to work with patients who disclose IPV. Our findings identify unmet needs within our health system to better train health care providers and restructure care models to support IPV identification and response. A focus on interprofessional training and care collaboration would bolster competency and reduce constraints felt by the health care workforce.

An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities

2016 ◽  
Vol 35 (2) ◽  
pp. 185-197
Author(s):  
Zaida Rahaman ◽  
Dave Holmes ◽  
Larry Chartrand
Keyword(s):  
Health Care ◽  
Critical Discourse Analysis ◽  
Health Care Providers ◽  
Critical Discourse ◽  
Care Providers ◽  
Aboriginal Communities ◽  
Semistructured Interviews ◽  
Aboriginal Patient ◽  
Aboriginal Person

Purpose: The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. Design: The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Methods: Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Findings: Within this research study, three significant findings emerged from the data. First, the Aboriginal person’s identity was constructed in relation to the health care provider’s role of delivering essential health services. Second, health care providers were not treating the “ill” patient, but rather treating the patient for being “ill.” Third, health care providers were treating the Aboriginal person for being “Aboriginal” by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being “Aboriginal.”

Understanding Financial Barriers to Care in Patients With Diabetes

2016 ◽  
Vol 43 (1) ◽  
pp. 78-86 ◽  
Author(s):  
David J. T. Campbell ◽  
Braden J. Manns ◽  
Brenda R. Hemmelgarn ◽  
Claudia Sanmartin ◽  
Alun Edwards ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Secondary Analysis ◽  
Care Providers ◽  
Financial Barriers ◽  
Face To Face ◽  
Semistructured Interviews ◽  
Patients With Diabetes ◽  
Data Saturation ◽  
The Impact

Purpose The purpose of this study was to better understand the impact that financial barriers have on patients with diabetes and the strategies that they use to cope with them. Methods A secondary analysis was conducted of 24 interviews with patients who had either type 1 or type 2 diabetes and perceived financial barriers, which were previously undertaken for a larger grounded theory study. Semistructured interviews were undertaken either face-to-face or by telephone. Data analysis was performed by 3 reviewers using inductive thematic analysis. Sampling for the original study continued until data saturation was achieved. Results The predominant aspects of care to which participants described financial barriers were medications, diabetes supplies, and healthy food. A variety of strategies are used by these patients. Participants described that their health care providers had the potential to either play an important supporting role; or alternatively, that they could also worsen the impacts of financial barriers. Conclusions Patients with diabetes experience financial barriers to various aspects of their care. While they use a variety of strategies to overcome their barriers, their health care providers can play a particularly important role in helping them manage these important barriers that impact their care and outcomes. Providers should ask patients about the existence of financial barriers, and employ strategies to mitigate against their impact.

scholarly journals Engaging Parents and Health Care Providers to Inform Development of a Behavioral Intervention Technology to Promote Pediatric Behavioral Health: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Sean M. O'Dell ◽  
Heidi R Fisher ◽  
Victoria Schlieder ◽  
Tracey Klinger ◽  
Rachel L Kininger ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Health Care Providers ◽  
Unmet Needs ◽  
Behavioral Health Care ◽  
Mixed Methods Study ◽  
Targeted Prevention ◽  
Care Providers ◽  
Current Practices

BACKGROUND Despite innovations to integrate behavioral health practitioners in primary care settings and online adaptations of effective parenting programs, access to care gaps persist for youth and families in need. Behavioral intervention technologies (BITs) represent a modality for targeted prevention with promise for transforming primary care behavioral health by empowering parents to take charge of their child’s behavioral health care. In order to realize the potential of BITs, research is needed to understand parental needs in a BIT, as well as the status quo of parent self-help and parent-provider collaboration to identify and address behavioral health challenges. OBJECTIVE Engage parents and health care providers to better understand unmet needs and current practices to inform continued development of a BIT for parents to address common behavioral health challenges. METHODS We conducted a convergence validation mixed methods study in which parent quantitative surveys (N=385) on preferences and current practices related to behavioral health themes to be addressed in a BIT were integrated with focus group interview data on internal and external contextual factors contributing to parental unmet needs and current practices with 48 health care stakeholders in 9 child-serving clinics within a large, predominantly rural health system. We integrated these data using joint displays and synthesized areas of confirmation, expansion, and discordance between parents and health care stakeholders. RESULTS Parents frequently endorsed about half of the available themes in their “top 3”, indicating that BITs may not be the preferred modality for all targeted prevention. Additionally, parents also frequently endorsed themes that were not related to child psychopathology (e.g., parenting stress and family communication), indicating parents are interested in guidance on parenting beyond challenging child behavior. Health care stakeholders indicated that an online platform aligns with how parents already seek behavioral health guidance and suggested that a BIT may connect families with evidence-based guidance sooner. We identified areas of convergence related to overt behavior problems (e.g., disruptive behavior, nutrition and eating), and areas of divergence related to internalizing problems and cross-cutting issues that may be more difficult for health care providers to detect. Data integration helped to expand our understanding with regard to factors that may lead to more effective parent-provider partnerships, including the impact of limited time pressure office visits and a deeper understanding of how unmitigated parenting stress interrelates with qualities of parent help-seeking behavior. CONCLUSIONS These findings provide a rich understanding of the complexity involved in meeting parents’ needs for behavioral health guidance in a primary care setting using BITs. Further triangulation of these findings in user testing studies for BIT prototypes is needed to refine our understanding of how to successfully develop and implement an effective BIT to guide parents in taking charge of their child’s behavioral health care. CLINICALTRIAL N/A

scholarly journals Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.

2020 ◽  
Author(s):  
Anara Zhumadilova ◽  
Aizhan Kozhakhmetova ◽  
Gaukhar Kuanyshbayeva ◽  
Madina Kazhen ◽  
Amina Akhmadiyeva ◽  
...  
Keyword(s):  
Health Care ◽  
Life Satisfaction ◽  
Health Care Providers ◽  
Care Providers ◽  
Medical Providers ◽  
Doctor Visit ◽  
Patient Centred Care ◽  
Patient Dissatisfaction ◽  
The Republic ◽  
The City

Abstract Background: Dissatisfaction among patients towards health care providers remains a serious concern in the Republic of Kazakhstan that requires further attention(1-3). Patient-centred care, trust between patients and medical providers, the involvement of patients in their own treatment process, and effective communication are major areas in need of strengthening in order to improve outcomes of medical care (4-7). The objective of this study was to broaden the investigation of patient dissatisfaction to various departments from different medical facilities in the city of Nur-Sultan and examine additional factors that may be influencing provider-patient communication and contributing to patient dissatisfaction. Methods: This cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from one private and one state hospital and two state policlinics (outpatient departments) in the city of Nur-Sultan, Kazakhstan, used questionnaires containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Results: Our study showed that the majority of health care providers and patients were doctor-centred as opposed to patient-centred in their expectations of the doctor visit. The patient-centred orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). Conclusions: The results of this study demonstrate that younger health care providers and those with lower life satisfaction expect a more patient-centred approach to the doctor visit. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centred attitudes. The majority of younger patients have a stronger belief in good health associated with patient-centred care whereas the older population preferred a more doctor-centred approach to care. In all patients, the preference for patient-centred care was associated with higher satisfaction in life.

scholarly journals Unmet Needs for Care and Medications, Cost as a Reason for Unmet Needs, and Unmet Needs as a Big Problem, due to Health-Care Provider (Dis)Continuity

2018 ◽  
Vol 5 (4) ◽  
pp. 258-266 ◽  
Author(s):  
Michelle L Stransky
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Unmet Needs ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Care Providers ◽  
Needs For Care ◽  
Unmet Needs For Care

Objective: Provider discontinuity is associated with poorer health-care outcomes compared to continuity in studies using retrospective reports of provider (dis)continuity. This study examined unmet needs for care and assessed cost as the reason for and the level of the problem resulting from unmet needs by provider (dis)continuity using longitudinal data. Methods: Pooled data on 10 714 working-age adults (aged 18-64) from the Medical Expenditure Panel Survey (panels 16 [2011-2012] and 17 [2012-2013]) were analyzed. Provider (dis)continuity was defined by 2 reports of having a health-care provider during the period. Results: Persons who lost providers were more likely to forego medical care and prescription medications, forego care due to cost, and report that delaying care was a big problem than their peers who experienced continuity. Persons who gained providers were more likely to delay dental care than those who always had, lost, or never had providers. Conclusions: Persons who experience discontinuity have poorer access to care than their peers who experience continuity. Public health initiatives should promote longitudinal relationships between persons and health-care providers.

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