scholarly journals Integrated health Services for Children: a qualitative study of family perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rose-Marie Satherley ◽  
Raghu Lingam ◽  
Judith Green ◽  
Ingrid Wolfe

Abstract Background There is increasing evidence that integrated care improves child related quality of life and reduces health service use. However, there is limited evidence on family perspectives about the quality of integrated care for children’s services. This study aimed to understand children, young people, and caregivers’ perceptions of a new integrated care service, and to identify essential components of integrated care for children and young people with ongoing conditions. Methods A qualitative analysis of in-depth interviews with caregivers and children included families (N = 37) with children with one of four ongoing conditions (asthma, eczema, epilepsy, constipation) who had experienced a new integrated care service delivered in South London, UK. Results Four key components of integrated services identified were: that the key health-worker understood the health needs of the family in context; that professionals involved children and caregivers in treatment; that holistic care that supported the family unit was provided; and that families experienced coordination across health, social, and education systems. Conclusions Children and families identify care navigation and a holistic approach as key components that make high quality integrated care services. Service developments strengthening these aspects will align well with family perspectives on what works and what matters.

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e040781
Author(s):  
Pim P Valentijn ◽  
Marcel Kerkhoven ◽  
Jantien Heideman ◽  
Rosa Arends

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.


2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Swarnali Bose ◽  
Bharati Roy

Fertility is considered as a marital responsibility in most the communities and a kind of social respectability for couples. The societal and parental pressures for propagation of the family name can also place a psychological burden on the infertile couple and may significantly affect quality of life. The present study aimed to investigate the gender differences in fertility related quality of life in primary infertility. 30 couples with primary infertility were recruited for the study after a written informed consent. Hindi version of FertiQoL was applied to all participants. Males had significantly better emotional, relational, social and global quality of life (QoL) as compared to females. Tolerability to infertility related problems was significantly better in females compared to males. This study found that primary infertility has extensive negative repercussions on the QOL of women as compared to males.


Author(s):  
E. Thiruvalluvan

Introduction: With the advent of Highly Active Antiretroviral Therapy (HAART) in 1996, HIV-infected patients are living longer and are concerned not only with treatment’s ability to extend their life butalso with the quality of the life they are able to lead, because, efficacy of treatment is strongly relatedto meaningful outcome i.e., better Quality of Life. Especially Health related quality of life has not been studied well. Hence, this study was necessitated with the objectives to evaluate Health Related Quality of Life (HRQoL) in HIV infected persons on ART. The secondary objectives were to assess the family burden experienced by the families of HIV infected, and measure influence of family burden on overall quality of life.Methodology: The HIV infected individuals who were started on treatment six months prior to date of interview were considered for the study The SF36 (Short Form with 36 questions) was used to evaluate function and mental Health while Pai and Kapur’s Family Burden Interview schedule was used to assess family burden. Interview schedule was pre-tested on 10 HIV infected individuals for consistency. Data analysis was performed using SPSS version 11 (SPSS inc. Chicago, IL, USA). Pearson product moment Correlation were computed to explore the relationships of SF36 with SLI, Family Burden and BMI. Further, Independent student “t” – test was performed to see the association between HRQoL and gender.Results: Of 91 participants interviewed 51.6% were women. Median age (years) of the respondents was 33. The overall mean score for Physical health was 45.13 SD (12.40) and for Mental health 56.91 SD (15.52). Age of HIV infected persons had significant influence in scores in social functioning (p-value .015), emotional well being scores (.015), and Mental health (.010). Socio life Index was directly related to physical health, mental health, Vitality, social functioning and emotional scores on HRQoL. Physicalhealth score was negatively affected by the Family burden score. Similarly, BMI status of the respondents correlated with Mental health, Body Pain, Vitality and Role emotional scores of HRQoL scale SF 36.Conclusion: Socio Life Index and BMI appear to be the two important predictors of HRQoL. Therefore, special attention may be required to HIV infected persons with lower SLI and BMI. Nutritional supplements, in addition to ART drugs, may be provided to ensure some improvements in physical functioning.SAARC J TUBER LUNG DIS HIV/AIDS, 2016; XIII(1), Page: 1-8


Author(s):  
R. Knapp ◽  
Z. Marshman ◽  
F. Gilchrist ◽  
H. Rodd

Abstract Objective To assess the impact of dental caries and treatment under general anaesthetic (GA) on the everyday lives of children and their families, using child-reported measures of quality of life (QoL) and oral health-related quality of life (OHRQoL). Method Participants, aged 5–16 years old having treatment for dental caries under GA, were recruited from new patient clinics at Charles Clifford Dental Hospital, Sheffield. OHRQoL was measured before and 3-months after treatment using the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). Overall QoL was measured using the Child Health Utility 9D (CHU9D). Parents/caregivers completed the Family Impact Scale (FIS). Results Eighty five parent–child dyads completed the study. There was statistically significant improvement in OHRQoL (mean interval score difference in CARIES-QC = 4.43, p < 0.001) and QoL (mean score difference in CHU9D = 2.48, p < 0.001) following treatment, with moderate to large effect sizes. There was statistically significant improvement in FIS scores (mean score difference = 5.48, p = 0.03). Conclusions Treatment under GA was associated with improvement in QoL and OHRQoL as reported by children, and reduced impacts on the family. This work highlights the importance of GA services in reducing the caries-related impacts experienced by children. Further work is needed investigate the impact of clinical, environmental and individual factors.


2016 ◽  
Vol 21 (6) ◽  
pp. 1580-1587 ◽  
Author(s):  
Mary M. Mitchell ◽  
Trang Q. Nguyen ◽  
Sarina R. Isenberg ◽  
Allysha C. Maragh-Bass ◽  
Jeanne Keruly ◽  
...  

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