scholarly journals The relationship between having a regular general practitioner (GP) and the experience of healthcare barriers: a cross-sectional study among young people in NSW, Australia, with oversampling from marginalised groups

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa Kang ◽  
Fiona Robards ◽  
Georgina Luscombe ◽  
Lena Sanci ◽  
Tim Usherwood
Keyword(s):  
Health Care ◽  
General Practice ◽  
Young People ◽  
Health System ◽  
Free Text ◽  
Cross Sectional ◽  
Healthcare Barriers ◽  
Positive Attitudes ◽  
Marginalised Groups ◽  
Barriers To Health

Abstract Background Young people (12–24 years) visit general practice but may not have a ‘regular’ general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of healthcare barriers and attitudes to health system navigation among young people in New South Wales (NSW), Australia. Methods This study was a cross-sectional survey administered either online or face-to-face in community settings. Young people living in NSW were recruited, with oversampling of those from five socio-culturally marginalised groups (those who were Aboriginal and Torres Strait Islander, homeless, of refugee background, in rural or remote locations, sexuality and/or gender diverse). In this analysis of a larger dataset, we examined associations between having a regular GP, demographic and health status variables, barriers to health care and attitudes to health system navigation, using chi-square tests and odds ratios. Content and thematic analyses were applied to free-text responses to explore young people’s views about having a regular GP. Results One thousand four hundred and sixteen young people completed the survey between 2016 and 2017. Of these, 81.1% had seen a GP in the previous 6 months and 57.8% had a regular GP. Cost was the most frequently cited barrier (45.8%) to accessing health care generally. Those with a regular GP were less likely to cite cost and other structural barriers, feeling judged, and not knowing which service to go to. Having a regular GP was associated with having more positive attitudes to health system navigation. Free-text responses provided qualitative insights, including the importance of building a relationship with one GP. Conclusions General practice is the appropriate setting for preventive health care and care coordination. Having a regular GP is associated with fewer barriers and more positive attitudes to health system navigation and may provide better engagement with and coordination of care. Strategies are needed to increase the proportion of young people who have a regular GP.

scholarly journals A decline in patient disclosure of heterosexuality in the English General Practice Patient Survey: a longitudinal analysis of cross-sectional data

2020 ◽  
Vol 37 (5) ◽  
pp. 661-667
Author(s):  
Harry Cross ◽  
Carrie D Llewellyn
Keyword(s):  
Health Care ◽  
General Practice ◽  
Sexual Orientation ◽  
Descriptive Analysis ◽  
Patient Survey ◽  
Cross Sectional ◽  
Orientation Data ◽  
Heterosexual Identity ◽  
Health Care Experiences ◽  
Practice Patient

Abstract Background Persistent health inequalities in relation to both health care experiences and health outcomes continue to exist among patients identifying with a marginalized sexual orientation (MSO). Objective To compare the patterns of sexual orientation disclosure within primary care in England over a 5-year period. Methods Descriptive analysis of cross-sectional, repeat measure, fully anonymized survey data of adults responding to the General Practice Patient Survey (GPPS) January 2012 to 2017. Participants from each year varied between 808 332 (2017) and 1 037 946 (2011/2012). Results The analysis samples comprised between 396 963 and 770 091 individuals with valid sexual orientation data depending on the year. For males, heterosexual disclosure decreased consistently from 92.3% to 91.2% from 2012 to 2017. Male patients reporting gay, bisexual and/or ‘other’ sexual orientations increased from 3.1% to 3.9%. For females, a larger reduction in heterosexual disclosure was recorded from 94% to 92.5%. Those reporting as lesbian, bisexual and/or ‘other’ increased from 1.82% to 2.68%, with the largest increase seen in the reporting of bisexuality, which nearly doubled from 2012 until 2017 (0.56–0.99%). Conclusion We found a year-on-year decline in patients reporting a heterosexual identity and an increase in the proportions of people reporting being either gay, bisexual, ‘other sexual orientation’ or preferring not to say. Heteronormative environments extend to health care settings, which may put increased stress on MSO individuals attending a GP practice. The introduction of environmental signs/symbols to show that a practice is inclusive of MSOs could reduce the potential stress experienced by patients.

scholarly journals Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Suad Ghaddar ◽  
Kristina P Vatcheva ◽  
Samantha G Alvarado ◽  
Laryssa Mykyta
Keyword(s):  
Health Care ◽  
Care Provider ◽  
Health Care Access ◽  
Intention To Use ◽  
Cross Sectional ◽  
Ehealth Literacy ◽  
Care Access ◽  
Positive Attitudes ◽  
Point Increase ◽  
Mexico Border

BACKGROUND Despite the United States having one of the leading health care systems in the world, underserved minority communities face significant access challenges. These communities can benefit from telehealth innovations that promise to improve health care access and, consequently, health outcomes. However, little is known about the attitudes toward telehealth in these communities, an essential first step toward effective adoption and use. OBJECTIVE The purpose of this study is to assess the factors that shape behavioral intention to use telehealth services in underserved Hispanic communities along the Texas-Mexico border and examine the role of electronic health (eHealth) literacy in telehealth use intention. METHODS We used cross-sectional design to collect data at a community health event along the Texas-Mexico border. The area is characterized by high poverty rates, low educational attainment, and health care access challenges. Trained bilingual students conducted 322 in-person interviews over a 1-week period. The survey instrument assessed sociodemographic information and telehealth-related variables. Attitudes toward telehealth were measured by asking participants to indicate their level of agreement with 9 statements reflecting different aspects of telehealth use. For eHealth literacy, we used the eHealth Literacy Scale (eHEALS), an 8-item scale designed to measure consumer confidence in finding, evaluating, and acting upon eHealth information. To assess the intention to use telehealth, we asked participants about the likelihood that they would use telehealth services if offered by a health care provider. We analyzed data using univariate, multivariate, and mediation statistical models. RESULTS Participants were primarily Hispanic (310/319, 97.2%) and female (261/322, 81.1%), with an average age of 43 years. Almost three-quarters (219/298) reported annual household incomes below $20,000. Health-wise, 42.2% (136/322) self-rated their health as fair or poor, and 79.7% (255/320) were uninsured. The overwhelming majority (289/319, 90.6%) had never heard of telehealth. Once we defined the term, participants exhibited positive attitudes toward telehealth, and 78.9% (254/322) reported being somewhat likely or very likely to use telehealth services if offered by a health care provider. Based on multivariate proportional odds regression analysis, a 1-point increase in telehealth attitudes reduced the odds of lower versus higher response in the intention to use telehealth services by 23% (OR 0.77, 95% CI 0.73-0.81). Mediation analysis revealed that telehealth attitudes fully mediated the association between eHealth literacy and intention to use telehealth services. For a 1-point increase in eHEALS, the odds of lower telehealth use decreased by a factor of 0.95 (5%; OR 0.95, 95% CI 0.93-0.98; <i>P</i>&lt;.001) via the increase in the score of telehealth attitudes. CONCLUSIONS Telehealth promises to address many of the access challenges facing ethnic and racial minorities, rural communities, and low-income populations. Findings underscore the importance of raising awareness of telehealth and promoting eHealth literacy as a key step in fostering positive attitudes toward telehealth and furthering interest in its use.

scholarly journals Evaluation of the elderlies’s attitudes towards young people Yaşlı bireylerin gençlere yönelik tutumlarının değerlendirilmesi

2016 ◽  
Vol 13 (2) ◽  
pp. 2682 ◽  
Author(s):  
Seda Kıpçak ◽  
Özden Dedeli
Keyword(s):  
Nursing Home ◽  
Statistical Analysis ◽  
Young People ◽  
Nursing Homes ◽  
Attitude Scale ◽  
Cross Sectional ◽  
Negative Attitudes ◽  
Positive Attitudes ◽  
Demographic Questionnaire ◽  
The Mean

The purpose of this study was to assess the elderlies who stay in nursing home’ attitudes towards young people. This study which is descriptive and cross sectional was conducted with 134 elderlies living in three nursing homes in Manisa (n=134). The data were collected by a demographic questionnaire and Attitude Scale Towards Young People (ASTYP). Kruskal Wallis, Mann Whitney U and  Spearman’ s rho correlation analysis were  used  in  statistical analysis. The mean age of elderlies were 74.0±6.7 (66-95) years,  69.4% were male. The elderlies’ mean scores of ASTYP were found 167.7 ± 12.7 (118.0-211.0).  The results of this study show that the elderlies, staying in nursing homes, have a negative attitudes towards young people. But; the elderlies, having more children and grandchildren than another and divorced or widowed, have more positive attitudes towards young people. ÖzetBu çalışmada amaç, huzurevinde kalan yaşlı bireylerin gençlere yönelik tutumlarının değerlendirilmesidir. Tanımlayıcı ve kesitsel tipteki araştırma, Manisa ili sınırları içerisinde üç huzurevinde yaşayan 134 yaşlı birey ile yürütüldü (n=134). Araştırmada veriler, araştırmacı tarafından sosyodemografik bilgiler soru formu ve Gençlere Yönelik Tutum Ölçeği (GYTÖ)’i kullanılarak toplandı. Verilerin değerlendirilmesinde, Kruskal Wallis, Mann Whitney U ve Spearman’s rho korelasyon analizleri kullanılmıştır. Araştırmaya katılan yaşlı bireylerin yaş ortalaması 74.0±6.7 yıl (66-95) olup büyük çoğunluğu (%69.4) erkekti. Yaşlı bireylerin GYTÖ’ den almış oldukları toplam puan ortalaması 167.7±12.7 (118.0-211.0)’ dir. Araştırma sonucunda, huzurevinde kalan yaşlı bireylerin gençlere yönelik olumsuz tutumlara sahip olduğu bulundu. Yaşlı bireylerin genel tutumları olumsuz olmasına rağmen çocuk ve torun sayısı fazla olan ve eşi ölmüş ya da boşanmış olan yaşlı bireylerin gençlere yönelik tutumları olumlu yöndeydi.

scholarly journals Perception on Oral Health and Recommendations for Improvement of Public Service Dental

2019 ◽  
Vol 21 (1) ◽  
pp. 65
Author(s):  
Suzely Adas Saliba Moimaz ◽  
Carlos Ayach ◽  
Léa Lofego ◽  
Cléa Adas Saliba Garbin ◽  
Orlando Saliba
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health System ◽  
The Self ◽  
Service Improvement ◽  
Health Evaluation ◽  
Self Assessment ◽  
Cross Sectional ◽  
Significance Level ◽  
Unified Health System

A participação social é uma importante ferramenta para o aprimoramento do Sistema Único de Saúde (SUS), fortalece a instituição de processos de avaliação do desempenho e contribui para a ampliação do acesso e qualidade dos serviços prestados. O objetivo foi avaliar a percepção dos usuários sobre a saúde bucal e as recomendações para melhoria do serviço público odontológico. Trata-se de um estudo transversal, tipo inquérito, com 390 usuários do SUS. As variáveis analisadas foram: autoavaliação da saúde bucal; avaliação da equipe e do serviço odontológico prestado. Realizou-se análise qualitativa das questões discursivas e teste estatístico de associação Qui-Quadrado ou Teste G, ao nível de significância de 5%. A autoavaliação da saúde bucal foi categorizada em muito boa/boa, regular, ruim/muito ruim e os motivos identificados da classificação foram: presença de doença, cuidado com a saúde, dor, educação em saúde, negligência com a saúde, tempo e medo. Quanto à avaliação da equipe e do serviço foram feitas sugestões para a melhoria, relacionadas à: infraestrutura, acesso, humanização e educação em saúde. Constatou-se associação significativa entre o cuidado com a saúde e a percepção positiva da saúde bucal. A presença de doença, negligência, tempo e medo influenciaram negativamente na autoavaliação. Como recomendações para melhoria do atendimento, 15,4% dos entrevistados apontou a infraestrutura; 8,2% o acesso; 6,9% a humanização e 1% a educação em saúde. Conclui-se que o cuidado com a saúde foi o fator mais relacionado a uma boa saúde bucal. Houve poucas recomendações para o aprimoramento da qualidade e resolutividade do serviço prestado. Palavras-chave: Avaliação em Saúde. Autoavaliação. Saúde Bucal. Abstract Social participation is an important tool for the improvement of the Brazilian Unified Health System, strengthens the institution of performance evaluation processes and contributes to the expansion of access and quality of services provided. This study evaluated user’s perceptions on oral health and recommendations for improvement of public dental services. This is a cross-sectional study, type inquiry, with 390 users of the Brazilian Unified Health System. The analyzed variables were self-assessment of oral health, evaluation of the team and the dental service provided. A qualitative analysis of the discursive questions was performed and Chi-square or G-test statistical association test, at a significance level of 5%. The self-assessment of oral health was categorized as very good/good, regular, bad/very bad and the identified reasons for the classification were: presence of disease, health care, pain, health education, negligence in health, time and fear. As for team and service evaluation, suggestions for improvement concerning infrastructure, access, humanization and education in health were made. It was found a significant association between health care and positive perception of oral health. The presence of disease, neglect, time and fear  affected negatively the  self-assessment. The recommendations for service improvement, 15.4% interviewed users pointed to infrastructure; 8.2% access; 6.9% humanization and 1% education in health. It is concluded that healthcare was the most frequent factor associated with good oral health. There were few recommendations for quality improvement and outcome of service provided.Keywords: Health Evaluation. Self-Assessment. Oral Health.

scholarly journals Knowledge, Attitude and Practices Related to COVID-19 Prevention among Health Care Workers in Sokoto Metropolis, Nigeria

2020 ◽  
pp. 44-61
Author(s):  
Oche M. Oche ◽  
Habibullah Adamu ◽  
Musa Yahaya ◽  
Ismail A. Raji ◽  
Hudu Garba Illo ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Workforce ◽  
Work Experience ◽  
Sampling Technique ◽  
P Value ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
Care Workers ◽  
Appropriate Practices

Aims: This study aims to assess the knowledge, attitude, and practices related to coronavirus pandemic among health care workers in Sokoto metropolis of Sokoto State, Nigeria.  Study Design: A cross-sectional study Place and Duration of Study: The study was conducted in Sokoto metropolis, northwest Nigeria between July and October 2020 Methodology: Four hundred and twenty-seven respondents were selected using a multi-stage sampling technique. Data were collected manually using a self-administered questionnaire entered into the computer for analysis using IBM SPSS version 25 for statistical analysis. Descriptive statistics, chi-square tests, and frequencies of the various variables were tabulated. Results: The mean age was 35.16+- 9.25 years, with those aged 30-39 years constituting 38% of the respondents. There were 53.2% males, 47.3% nurses, and 27.2% doctors, and 71.6% of the respondents were from tertiary health institutions, out of which 42% had 1-5 years of work experience. Up to 99% were aware of coronavirus 2019 (COVID-19), and overall, 78.2% had good knowledge, and 91% of all the respondents had positive attitudes towards the pandemic (p-value 0.001). Overall, 68.4% of the health workforce had appropriate practices towards preventing COVID-19, and 83% were willing to be posted to isolation centers with adequate personal protective equipment (PPE). Conclusion: The study demonstrated significant awareness and knowledge of COVID-19 amongst the health workforce in Sokoto with significant positive attitudes towards the pandemic and appropriate practices towards preventing the pandemic and willingness to work in isolation centers to support the prevention of the pandemic.

scholarly journals Health services utilisation and responsiveness profiles in Iran: a provincial household study

2019 ◽  
Vol 7 (1) ◽  
pp. e000007 ◽  
Author(s):  
Mostafa Farahbakhsh ◽  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mina Golestani ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Health Resources ◽  
Cross Sectional ◽  
The Public ◽  
Significant Difference ◽  
System Responsiveness ◽  
Health System Responsiveness ◽  
East Azerbaijan ◽  
Barriers To Health

ObjectiveThe aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province, Iran.DesignA cross-sectional household study as part of a larger research on primary healthcare system.SettingWe carried out the study in East Azerbaijan Province, northwest Iran from July to September 2015.ParticipantsA total of 1318 households were included.ResultsMost of the participating households had social security health insurance. Heart failure or hypertension care, general outpatient care and arthritis care were the most used services. High services cost and inadequate medicine and medical equipment were introduced to be the main barriers to health services utilisation in Tabriz and province representative sample (PRS), respectively. Health system responsiveness mean score (the maximum is 100) was 33.71±16.15 (95% CI 32.45 to 34.97) in Tabriz and 32.02±14.3 (95% CI 30.9 to 33.13) in PRS, which showed significant difference (p≤0.02).ConclusionsDifferences in the utilisation and responsiveness of health services and distribution of health resources were observed between Tabriz and PRS. Evidently, health system responsiveness in both Tabriz and PRS was at low level. The results demonstrate the need for changing resource distribution policies and employing reactive health policies to response the public health.

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