Barriers to Accessing Healthcare: Perspectives from Autistic Adults and Carers

2021 ◽  
pp. 104973232110503
Author(s):  
Shenae Calleja ◽  
Jonathan Kingsley ◽  
Fakir M Amirul Islam ◽  
Rachael McDonald
Keyword(s):  
Mental Health ◽  
Healthcare Access ◽  
Primary Caregivers ◽  
Phenomenological Approach ◽  
Health Needs ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Face To Face ◽  
Autistic Adults ◽  
Perceived Experiences

Autistic adults have higher health needs compared to most, yet they continue to experience barriers to accessing appropriate healthcare. Presently, no qualitative research exists exploring these barriers which impact overall physical and mental health. We conducted a qualitative analysis in Victoria (Australia) of the perceived experiences of healthcare access for autistic adults ( n = 9) and primary caregivers of autistic adults ( n = 7). Specifically, a three-staged phenomenological approach was applied involving: (i) a communicative checklist, (ii) a health status survey and (iii) face-to-face interviews. Elements such as support, responsibilities and protective factors exhibited by caregivers, may impact healthcare access for autistic adults. Results indicate the need for further research exploring interdependent factors that impact healthcare access by caregivers, so evidence-based interventions can be developed to support caregivers in the future.

Presence of a Secondary Caregiver Differentiates Primary Cancer Caregiver Well-being

2021 ◽  
Author(s):  
Maria Thomson ◽  
Maureen Wilson-Genderson ◽  
Laura A Siminoff
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Multilevel Models ◽  
Case Series ◽  
Primary Caregivers ◽  
Well Being ◽  
Physical And Mental Health ◽  
Hematological Cancer ◽  
Cancer Caregiver ◽  
Over Time

Abstract Background Informal caregivers play a fundamental role in the care of hematological cancer patients, but less is known about how secondary caregivers are involved. We assessed the presence or absence of a secondary caregiver, the types of caregiving activities performed by primary and secondary caregivers and examined whether the presence of a secondary caregiver was associated with primary caregiver characteristics and wellbeing over time. Methods A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Multi-level models were developed to examine the associations between presence of a secondary caregiver and the primary caregivers’ well-being. Results Most (64.9%) primary caregivers reported having secondary caregivers. Multilevel models showed primary caregivers without help had higher baseline mental and physical health, but experienced deteriorating physical health overtime, compared to supported primary caregivers. Supported primary caregivers reported improvements in mental health over time that was associated with improvements in physical health. Conclusions Primary caregivers in good physical and mental health at the beginning of their caregiving journey but who have the least assistance from others may be at greatest risk for detrimental physical health effects long term. Attention to the arrangement of caregiving roles (i.e., who provides what care) overtime is needed to ensure that caregivers remain healthy and well supported.

A systematic review of Karen refugee health

2016 ◽  
Vol 12 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Sarah J. Hoffman ◽  
Cheryl L. Robertson
Keyword(s):  
Mental Health ◽  
Forced Migration ◽  
The Body ◽  
Health Needs ◽  
Health Providers ◽  
Physical And Mental Health ◽  
Content Type ◽  
And Migration ◽  
Karen Refugees ◽  
The Impact

Purpose – The purpose of this paper is to provide a comprehensive perspective of the documented physical and mental health issues Karen refugees from Burma face as a result of war and refugee trauma, and migration. The review will address the question: What is the impact of trauma and migration on the physical and mental health of Karen refugees? Design/methodology/approach – A total of 18 articles were systematically selected for inclusion in the final review. The focal content for included articles includes qualitative and quantitative research representative of the health and migration experiences of Karen refugees. Findings – The findings of this review demonstrate significance for health providers from a public health standpoint as programs and services are targeted to meet the specific health needs of the Karen community. It also highlights the contribution of the Karen forced migration experience to the complexity of individual and community health needs, particularly as a result of the protracted conflict. Originality/value – This critical appraisal of the body of literature describing the health experiences of Karen refugees from Burma, with a particular focus on outcomes relevant to resettlement, demonstrates value as programs are developed with an integrated refugee perspective.

Occupational Therapy Practitioners’ Perspectives of Mental Health Practices With Clients in Stroke Rehabilitation

2018 ◽  
Vol 38 (3) ◽  
pp. 181-189 ◽  
Author(s):  
Emily K. Simpson ◽  
Narissa M. Ramirez ◽  
Brittany Branstetter ◽  
Aileen Reed ◽  
Evan Lines
Keyword(s):  
Mental Health ◽  
Occupational Therapy ◽  
Online Survey ◽  
Emotional Health ◽  
The United States ◽  
Health Needs ◽  
Physical And Mental Health ◽  
Mental Health Needs ◽  
Post Stroke ◽  
Mental Health Practices

Following a stroke, depression and anxiety may negatively affect recovery and decrease quality of life. Occupational therapy (OT) practitioners are distinctly qualified to address both the physical and psychosocial sequelae of a stroke, including clients’ mental and emotional health. This study explored the ways in which OT practitioners address the mental health needs of clients post stroke. A sequential explanatory mixed-methods design was used to collect both survey and focus group data. In all, 754 OT practitioners across the United States completed an online survey, and 10 practitioners participated in focus groups. Practitioners considered their clients’ mental health needs to be a priority (68.17%); however, only 56.64% were satisfied with the care they provided related to mental and emotional health. They identified barriers that included limited time, increased productivity standards, expectations related to physical recovery, and poor educational preparation. Practitioners are motivated to improve their provision of mental health services to clients post stroke. To address the conflict between practice realities and professional values, education programs should better integrate curricular components that focus on physical and mental health.

scholarly journals Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

2020 ◽  
Author(s):  
Mary Doherty ◽  
Stuart D Neilson ◽  
Jane D O'Sullivan ◽  
Laura Carravallah ◽  
Mona Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Clinic Appointment ◽  
Autistic People ◽  
Autistic Adults

AbstractBackgroundAutistic people experience significantly poorer physical and mental health along with reduced life expectancy.AimTo identify self-reported barriers to primary care by autistic adults compared to parents of autistic children and non-autistic adults and link these barriers to self-reported adverse health consequences.Design and SettingFollowing consultation with the autistic community at an autistic conference, Autscape, a quantitative and qualitative survey was developed.MethodThe self-report survey was administered online through social media platforms.ResultsThe 57-item online survey was completed by 507 autistic adults, 196 parents of autistic children and 157 control subjects. 79.7% of autistic adults, 52.8% of parents and 36.5% of controls reported difficulty visiting a GP. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72.2%), difficulty making appointments by telephone (61.9%), not feeling understood (55.8%), difficulty communicating with their doctor (53.1%) and the waiting room environment (50.5%).Autistic adults reported a preference for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait.Increased adverse health outcomes reported by autistic adults correlated with difficulty attending, including untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions.ConclusionReduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives and communication needs. Adjustments for autism specific needs are as necessary as ramps for wheelchair users.How this fits inAdverse health outcomes are common among autistic people and so it is important to understand how we can promote access to primary care.This cross sectional study indicates that 79.7% of autistic patients (compared to 36.5% of controls) reported difficulty visiting a GP.Common barriers were: deciding if symptoms warrant a GP visit, difficulty using the telephone to book appointments, not feeling understood and difficulty communicating with their doctor.Common suggestions to promote access included: online or text based appointment booking facility, emailing in advance the reason for consultation, providing first or last clinic appointment and having a quiet place to wait.

scholarly journals Responding to challenges for people with psychotic illness: Updated evidence from the Survey of High Impact Psychosis

2016 ◽  
Vol 51 (2) ◽  
pp. 124-140 ◽  
Author(s):  
Vera A Morgan ◽  
Anna Waterreus ◽  
Vaughan Carr ◽  
David Castle ◽  
Martin Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Social Isolation ◽  
Social Engagement ◽  
High Impact ◽  
High Rate ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Psychotic Illness ◽  
Violent Victimisation

Objective: The objective is to summarise recent findings from the 2010 Australian Survey of High Impact Psychosis (SHIP) and examine their implications for future policy and planning to improve mental health, physical health and other circumstances of people with a psychotic disorder. Methods: Survey of High Impact Psychosis collected nationally representative data on 1825 people with psychotic illness. Over 60 papers have been published covering key challenges reported by participants: financial problems, loneliness and social isolation, unemployment, poor physical health, uncontrolled symptoms of mental illness, and lack of stable, suitable housing. Findings are summarised under the rubric of participant-ranked top challenges. Results: The main income source for the majority (85%) of participants was a government benefit. Only one-third was employed, and the most appropriate employment services for this group were under-utilised. High rates of loneliness and social isolation impacted mental and physical health. The rate of cardiometabolic disease was well above the general population rate, and associated risk factors were present from a very young age. Childhood abuse (30.6%), adult violent victimisation (16.4%) and alcohol and substance abuse/dependence (lifetime rates of 50.5% and 54.5%, respectively) complicated the clinical profile. Treatment with medication was suboptimal, with physical health conditions undertreated, a high rate of psychotropic polypharmacy and underutilisation of clozapine in chronic persistent psychotic illness. Only 38.6% received evidence-based psychosocial therapies. In the previous year, 27.4% had changed housing and 12.8% had been homeless, on average for 155 days. Conclusion: Money, social engagement and employment are the most important challenges for people with psychotic illness, as well as good physical and mental health. An integrated approach to recovery is needed to optimise service delivery and augment evidence-based clinical practice with measures to improve physical health and social circumstances. Meeting these challenges has the potential to reduce costs to government and society, as well as promote recovery.

scholarly journals Identified Challenges from Faculty Teaching at Predominantly Undergraduate Institutions after Abrupt Transition to Emergency Remote Teaching during the COVID-19 Pandemic

2021 ◽  
Vol 11 (9) ◽  
pp. 556
Author(s):  
Blake C. Colclasure ◽  
AnnMarie Marlier ◽  
Mary F. Durham ◽  
Tessa Durham Brooks ◽  
Mekenzie Kerr
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
Learning Community ◽  
Teaching And Learning ◽  
Physical And Mental Health ◽  
Midwest United States ◽  
Face To Face ◽  
Faculty Teaching ◽  
Learning Patterns ◽  
Undergraduate Institutions

COVID-19 has been one of the most significant disruptors of higher education in modern history. Higher education institutions rapidly transitioned to Emergency Remote Teaching (ERT) in mid-to-late March of 2020. The extent of COVID-19’s impact on teaching and learning, and the resulting challenges facilitating ERT during this time, likely varied by faculty, institutional, and geographical characteristics. In this study, we identified challenges in teaching and learning during the initial transition to ERT at Predominantly Undergraduate Institutions (PUIs) in the Midwest, United States. We conducted in-depth interviews with 14 faculty teaching at Midwestern PUIs to explore their lived experiences. We describe the most overarching challenges related to faculty teaching through four emergent themes: pedagogical changes, work-life balance, face-to-face interactions, and physical and mental health. Five themes emerged that we used to describe the most overarching challenges related to students and their learning: learning patterns, technology access, additional responsibilities, learning community, and mental health. Based upon the identified challenges, we provide broad recommendations that can be used to foster a more successful transition to ERT in unforeseen regional or global crises in the future.

scholarly journals Delivering a Tai Chi Intervention to Adults Aging with Mobility Disabilities Using Zoom

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 425-425
Author(s):  
Elena Remillard ◽  
Kara Cohen ◽  
Lelah Cochran ◽  
Tracy Mitzner
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Tai Chi ◽  
Lessons Learned ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Virtual Group ◽  
Exercise Classes ◽  
Made In

Abstract Many individuals aging with mobility disabilities experience barriers to participating in physical activity, including transportation challenges and the need for specialized instruction. Since the COVID-19 pandemic began, these participation barriers have been amplified due to lockdowns and restrictions. Tele-technologies, including videoconferencing platforms like Zoom, can facilitate access to exercise classes from one’s home. Virtual group exercise classes that incorporate social interaction have particular potential to support the physical and mental health of this population. This session will highlight lessons learned from launching the ‘Tele Tai Chi’ study, in which we are delivering an evidence-based Tai Chi program (Tai Chi for Arthritis) via Zoom to small group classes of older adults with long-term mobility disabilities. We will describe adaptations made in translating the in-person program to an interactive, online class, and provide an overview of a ‘Telewellness’ Tool that provides guidelines for using Zoom to deliver exercise classes to older adults.

scholarly journals Harnessing the Power of Community in Pursuit of Zero Suicide

2019 ◽  
Author(s):  
Louis T Joseph ◽  
Chun-Yi Wu
Keyword(s):  
Mental Health ◽  
Suicide Rate ◽  
Task Force ◽  
Health Needs ◽  
Evidence Based ◽  
Community Based ◽  
Needs Assessments ◽  
Kennedy Space Center ◽  
Kennedy Space ◽  
Pediatric Mental Health

The Zero Suicide movement is an international movement which aims to eliminate suicide by way of radical healthcare system redesign1. In early 2017, within Brevard County, Florida, an international hub for aerospace and home to the Kennedy Space Center, a community based task force was assembled to intervene when the pediatric suicide rate reached one of the highest rates in the State of Florida. Pediatric Mental Health was previously identified as a top priority on multiple community health needs assessments performed by organizations throughout the region. Within the ensuing 24 months, a community wide evidence based technical package to prevent suicide was implemented and the pediatric suicide rate was reduced to near zero, the lowest rate the region had seen in over 20 years.

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