Decreased Access to Health Care and Social Isolation among Young Adults with Cerebral Palsy after Leaving School

Objective. T o examine if leaving special schools has a negative impact on the health care and social isolation of young adults with cerebral palsy. Methods. Young adults with cerebral palsy, aged between 15 and 22 years, were divided into 2 cohorts: current students, who were still receiving services from special schools, and school-leavers, who had since been discharged from care. A questionnaire and physical examination were administered to assess the extent of disability, health care received by, and social isolation of these young adults. Results. School-leavers had a greater degree of dissability than did students, although the results were not statistically significant. Health care exposure to specialists, general practitioners, therapists (physiotherapists, occupational therapists, and/or speech therapists), and medical social workers decreased after leaving school; with the exception of contact with general practitioners, these results were significant (p<0.05). The entire cohort was more socially isolated than a control cohort. School-leavers participated in fewer activities outside their homes, but showed less concern about their disability than did current students. Conclusions. Young adults with cerebral palsy continue to have health care and lifestyle needs after leaving school, which are currently not being adequately met.

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Challenges experienced by mothers caring for children with cerebral palsy in Zambia

South African Journal of Physiotherapy ◽

10.4102/sajp.v71i1.274 ◽

2015 ◽

Vol 71 (1) ◽

Cited By ~ 3

Author(s):

Carol Singogo ◽

Margaret Mweshi ◽

Anthea Rhoda

Keyword(s):

Health Care ◽

Cerebral Palsy ◽

Social Isolation ◽

Health Care Providers ◽

Health Care Professionals ◽

Care Providers ◽

Community Members ◽

Marital Problems ◽

Children With Cerebral Palsy ◽

Socially Isolated

Background: Mothers caring for children with disability experience a number of challenges.Aim: The aim of the study was to explore the challenges that mothers who cared for children with cerebral palsy (CP) living in Zambia experienced.Methods: During a qualitative study the experiences of 16 conveniently sampled mothers of children with CP, from the Ndola district in Zambia, were explored by means of interviews. The responses were thematically analysed. All the necessary ethical considerations were upheld.Results: Mothers experienced social isolation and marital problems, as well as negative attitudes from family, friends, community members and health care professionals. The physical environment created access challenges because of a lack of sidewalks, ramps, functioning lifts and small indoor spaces.Conclusion: Mothers of children with CP feel socially isolated owing to a lack of support from family, community members, and health care providers. This social isolation was exacerbated by attitudes of others towards the mothers; it was felt that mothers were responsible for their children’s condition. Mothers also experienced marital problems as a result of having a child with CP.

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High and daily exposure to precariousness negatively impacts the prescriptions of general practitioners to precarious populations: an observational pharmaco-epidemiological study investigating inequalities in access to health care in France

10.21203/rs.3.rs-609612/v1 ◽

2021 ◽

Author(s):

François BIRAULT ◽

Lakshmipriva LE BONHEUR ◽

Sandivanie CLODION ◽

Nematollah JAAFARI ◽

Marie-Christine PERAULT-POCHAT ◽

...

Keyword(s):

Health Care ◽

Epidemiological Study ◽

General Practitioners ◽

Repeated Measures ◽

Access To Health Care ◽

Negative Impact ◽

Cromolyn Sodium ◽

Defined Daily Dose ◽

Daily Exposure ◽

Access To Health

Abstract Background The association between precariousness and lack of access to health care is well-documented. Prescribing drugs is one promising marker for this health care inequality. A recent study, carried out on the entire French population, has developed a new measurement model based on the 20 most prescribed molecules. It reports that drugs, targeting diseases known to more affect precarious populations, are under-prescribed by general practitioners (GP) to these populations. If these findings highlight unequal drugs prescriptions between populations despite epidemiological factors, it is still unknown whether a high and daily exposure to precariousness negatively impacts GPs prescriptions. Here, we investigated whether there are more inequalities in prescriptions of GPs who are highly and daily exposed to precariousness, compared to GPs who are less exposed to precariousness. Methods This retrospective pharmaco-epidemiological study compared the Defined Daily Dose relative to different reimbursed drugs prescribed by GPs to precarious and non-precarious patients in four French regions respectively with low and high precariousness prevalence in 2015. Data were analyzed using repeated-measures ANOVAs (Sphericity correction: Greenhouse-Geisser; Post-Hoc Tests, Bonferroni corrected). Results 2 out of 20 molecules were significantly over-prescribed (tamsulosine and timolol) and 7 were under-prescribed (amoxicillin, econazole, ciclopirox, prednisolone, paracetamol, cromolyn sodium, ibuprofen) to precarious populations in regions with high precariousness prevalence. Conclusions The over-reimbursement of tamsulosine and timolol did not reflect the negative impact of exposure to precariousness on the GPs prescriptions but a failure of the health system to compensate for inequalities in access to chirurgical treatments. In contrast, the under-reimbursement of amoxicillin, ciclopirox and econazole indicated an effect of the exposure to precariousness on GPs’ prescriptions, these molecules targeting acute diseases that affect more significantly precarious than non-precarious populations. The same explanation is probably suitable for the under-reimbursement of prednisolone, paracetamol, cromolyn sodium, and ibuprofen, although their various indications render difficult to delimitate the clinical purpose at the basis of their prescription. We assume that exhausting working conditions, repeated exposures to difficult living conditions, and repeated experiences of failure impairs empathic skills in GPs, leading to burnout which negatively impacts the quality of care and, thus, prescriptions.

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Access to healthcare and self-rated health among refugees in transit and after arrival in Norway

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.828 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Haj-Younes ◽

E Strømme ◽

W Hasha ◽

J Igland ◽

E Abildsnes ◽

...

Keyword(s):

Health Care ◽

Host Country ◽

Access To Health Care ◽

Negative Impact ◽

Minority Group ◽

Access To Healthcare ◽

Syrian Refugees ◽

Self Rated Health ◽

Perceived Access ◽

In Transit

Abstract Background Lack of basic infrastructure and poor provision of health services in conflict settings and during flight can have a negative impact on health. The overall health status of refugees seems to improve after arrival at a safe destination. This may be related to a safer environment and better access to health care services, but prior studies on this topic are limited. This study aims to assess self-perceived access to healthcare and its relationship with self-rated health (SRH) among refugees in transit and when settled in a host country. Methods We used data from the CHART study (Changing Health and health care needs Along the Syrian Refugees' Trajectories to Norway), which includes a cohort of 353 Syrian refugees who were contacted in 2017-2018 in Lebanon while waiting for relocation, and one year after their arrival to Norway. Information on self-perceived access to healthcare and its association with SRH was analyzed separately at each time-point. Data analysis was performed with STATA using logistic regression adjusting for age, gender, ethnicity and years of education and presented as adjusted odds ratios (AOR) with 95% CI. Results Fifteen percent reported good access to healthcare and 62% reported good SRH in Lebanon vs. 91% and 77% respectively, in Norway. Measures in Lebanon showed no association between access to healthcare and good SRH (AOR: 1.2 (0.6-2.2)), and men reported worse access to healthcare than women (AOR: 0.5 (0.3-1.0). In Norway, access to healthcare was strongly associated with good SRH (AOR: 4.7 (2.1-10.7) and was negatively associated with belonging to one specific minority group (AOR: 0.1 (0.0-0.3)). Conclusions Both SRH and perceived access to care improved from being in transit to being settled in Norway, the latter substantially more. There was a significant association between access to healthcare and good SRH after the refugees' arrival to a safe host country but not in transit. Key messages Refugee’s self-reported health and access to healthcare seem to improve shortly after arrival to a host country. To ensure that the UN’S Sustainable Development Goals concerning health equity are reached, refugees’ access to healthcare in transit and its impact on overall health needs to be addressed.

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Educational outcomes of children in Wales with cerebral palsy

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1254 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Hywel Jones ◽

Bethan Carter ◽

Jackie Bethel ◽

Verity Bennett ◽

Sarah Rees ◽

...

Keyword(s):

Health Care ◽

Cerebral Palsy ◽

School Attendance ◽

National Curriculum ◽

Area Deprivation ◽

Special Educational Needs ◽

Special Schools ◽

Data Set ◽

Education Data ◽

Teacher Assessments

Background with rationaleIt is recognized that children with disability have special educational needs (SEN). They are likely to have poor school attendance and do not achieve well academically. Many children with a cerebral palsy (CP) have SEN but little is known about their educational provision or outcomes. Main AimTo investigate the educational experience of children in Wales with CP and describe the type of SEN and SEN provision; school attendance; achievement—teacher assessments at the end of the Foundation Phase and Key Stages 2 and 3 of the National Curriculum (NC)—and in General Certificate of Secondary Education (GCSE) examinations. Methods/ApproachData from the Pupil Level Annual School Census (PLASC), NC and GCSE results from 2009 to 2016 were linked with routine e-health records of primary and secondary health care data held in SAIL. The health care records were used to identify pupils who, potentially, had a cerebral palsy. ResultsThe linked data set included around 360,000 pupils per school census of whom 1200–1400 per school census were identified as having a CP, representing a crude prevalence of 0.4%. Adjusted for age, year and sex, there was no significant variation in prevalence by area deprivation. Around 60% of children with a CP have a statement of SEN; over a quarter of CP children are educated in special schools; CP children in mainstream (primary, middle and secondary) schools tended to miss more school sessions (~50% more) than other children and lower percentages achieved the expected levels at Key Stages 2 and 3 and the Level 2 GCSE threshold. Conclusion/Implications This work demonstrates the utility of record-linkage between health and education data to map, monitor and provide information to parents, carers and policymakers about education outcomes for this group of children to inform planning and service provision.

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How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?

Primary Health Care Research & Development ◽

10.1017/s1463423616000268 ◽

2016 ◽

Vol 17 (06) ◽

pp. 578-585 ◽

Cited By ~ 4

Author(s):

Anette L. Hindhede ◽

Ane Bonde ◽

Jasper Schipperijn ◽

Stine H. Scheuer ◽

Susanne M. Sørensen ◽

...

Keyword(s):

Health Care ◽

General Practitioners ◽

Catchment Area ◽

Access To Health Care ◽

Health Care Services ◽

Economic Status ◽

Health Care Systems ◽

Economic Vulnerability ◽

Initial Appointment ◽

Planned Activities

AimThe aim was to explore the extent to which a Danish prevention centre catered to marginalised groups within the catchment area. We determined whether the district’s socio-economic vulnerability status and distance from the citizens’ residential sector to the centre influenced referrals of citizens to the centre, their attendance at initial appointment, and completion of planned activities at the centre.BackgroundDisparities in access to health care services is one among many aspects of inequality in health. There are multiple determinants within populations (socio-economic status, ethnicity, and education) as well as the health care systems (resource availability and cultural acceptability).MethodsA total of 347 participants referred to the centre during a 10-month period were included. For each of 44 districts within the catchment area, the degree of socio-economic vulnerability was estimated based on the citizens’ educational level, ethnicity, income, and unemployment rate. A socio-economic vulnerability score (SE-score) was calculated. Logistic regression was used to calculate the probability that a person was referred to the centre, attended the initial appointment, and completed the planned activities, depending on sex, age, SE-score of district of residence, and distance to the centre.FindingsCitizens from locations with a high socio-economic vulnerability had increased probability of being referred by general practitioners, hospitals, and job centres. Citizens living further away from the prevention centre had a reduced probability of being referred by their general practitioners. After referral, there was no difference in probability of attendance or completion as a function of SE-score or distance between the citizens’ district and the centre. In conclusion, the centre is capable of attracting referrals from districts where the need is likely to be relatively high in terms of socio-economic vulnerability, whereas distance reduced the probability of referral. No differences were found in attendance or completion.

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Access to Health Care for Young Adults With Disabling Chronic Conditions

Archives of Pediatrics and Adolescent Medicine ◽

10.1001/archpedi.160.2.178 ◽

2006 ◽

Vol 160 (2) ◽

pp. 178 ◽

Cited By ~ 53

Author(s):

S. Todd Callahan ◽

William O. Cooper

Keyword(s):

Health Care ◽

Young Adults ◽

Chronic Conditions ◽

Access To Health Care ◽

Access To Health

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Isolation and well-being in the time of lockdown

REGION ◽

10.18335/region.v8i2.350 ◽

2021 ◽

Vol 8 (2) ◽

pp. 83-97

Author(s):

Lise Bourdeau Lepage ◽

Balázs Kotosz

Keyword(s):

Social Isolation ◽

Negative Impact ◽

Well Being ◽

Primary Objective ◽

Living Alone ◽

Health Crisis ◽

Social Distancing ◽

Face To Face ◽

The Social ◽

Socially Isolated

In response to the Covid‑19 health crisis, the French government has imposed various measures, referred to as social-distancing measures, including a lockdown with the primary objective of reducing face-to-face interactions between people in order to limit the spread of the virus. This paper seeks to determine if the social-distancing measures and lockdown lead to social isolation for certain people and have an impact on French people’s well-being. First, it reveals that the feelings of social isolation have substantially increased in France during this lockdown. Second, it explores the factors that help to explain these changes by developing a predictive model and reveals that living alone, being a woman, being young are factors that explain this increase in felling of social isolation. Third, the estimation of the effects of changes in feelings of social isolation on changes in the reported level of well-being of French respondents during lockdown shows that people who reported feeling more socially isolated than others has the lowest levels of well-being among the French population; and that the increase in people’s feelings of social isolation during lockdown is a factor that has a negative impact on their level of well-being.

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“To be lonely in your own loneliness” – The interplay between self-perceived loneliness and rheumatoid arthritis in everyday life: A qualitative study

10.21203/rs.2.18197/v1 ◽

2019 ◽

Author(s):

Laila Twisttmann Bay ◽

Torkell Ellingsen ◽

Annamaria Giraldi ◽

Christian Graugaard ◽

Dorthe Nielsen

Keyword(s):

Rheumatoid Arthritis ◽

Health Care ◽

Qualitative Study ◽

Everyday Life ◽

Social Isolation ◽

Negative Impact ◽

Narrative Approach ◽

Structured Interviews ◽

Health Care Practitioners ◽

Insight Into

Abstract Background: Loneliness has a negative impact on physical health, and rheumatoid arthritis symptoms can lead to social isolation. However, there is a lack of research exploring patients’ perspectives on self-perceived loneliness in everyday life with rheumatoid arthritis. The purpose of this study was to gain insight into the meaning and importance of self-perceived loneliness among adult patients diagnosed with rheumatoid arthritis.Methods: Semi-structured interviews analyzed within a narrative thematic framework.Results: Three themes emerged during the analysis: explanations of loneliness in everyday life with rheumatoid arthritis, disclosing or disguising loneliness, and feelings of loneliness in social life.Conclusion: The findings from this study show that loneliness can be burdensome when living with RA. Narratives of loneliness can be hard for patients to disclose, so health care practitioners should take responsibility for legitimizing this subject. A narrative approach in consultations may be helpful to support patients and to encourage a dialogue about loneliness in everyday life with RA.

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