scholarly journals LGBT health-care disparities in Multiple Sclerosis: a cross-sectional web-based study in Italy (Preprint)

2016 ◽  
Author(s):  
Luigi Lavorgna ◽  
Marcello Moccia ◽  
Antonio Russo ◽  
Raffaele Palladino ◽  
Lucia Riccio ◽  
...  

BACKGROUND Lesbian, gay, bisexual and transgender (LGBT) patients might experience unique difficulties and barriers to treatment of chronic diseases related to their sexual orientation. OBJECTIVE To investigate health-care disparities experienced by LGBT patients with multiple sclerosis (MS). METHODS We conducted a survey on an Italian social-network (www.smsocialnetwork.com) for MS patients, by using standardized multiple-choice questions. The survey investigated: socio-demographic factors, lifestyle habits, MS-related health status and LGBT specific issues (e.g. friendliness to their sexual orientation or homophobic behaviors from the staff of their MS Center). RESULTS LGBT patients were associated with a smaller number of psychological consultations, compared to heterosexuals (Coeff.=-0.449; p<0.001; 95%CI=-0.682--0.217). LGBT patients were more likely to change MS Center, compared to heterosexuals (OR=2.064; p=0.046; 95%CI=1.011-4.212). The number of MS Center changes was associated with MS Center friendliness (p=0.037; rho=-0.229) and with the occurrence of homophobic behaviors (p=0.036; rho=0.234). CONCLUSIONS LGBT MS patients more frequently changed MS Center and had a reduced use of psychological services, compared to heterosexuals. The attitude towards LGBT MS patients might affect resource utilizations and, possibly, LGBTs’ health status.

2017 ◽  
Vol 13 ◽  
pp. 28-32 ◽  
Author(s):  
Luigi Lavorgna ◽  
Marcello Moccia ◽  
Antonio Russo ◽  
Raffaele Palladino ◽  
Lucia Riccio ◽  
...  

Author(s):  
M. Trajchevska ◽  
A. Lleshi ◽  
S. Gjoshev ◽  
A. Trajchevski

Background: The respect of the needs and wishes of the patients is in the focus of the human health system. The experience of the parents in terms of child’s health care may be used as an indicator of quality of the health care. Material and methods: The research is a quantitative analytical cross-sectional study. In accordance with the inclusion and exclusion criteria, simple random sample of 207 parents / guardians is covered, whose children in the period of three months, had been hospitalized in the hospital department JZUU Pediatric Surgery Clinic in Skopje.It was used a two parted questionnaire. The first part is a standardized questionnaire (Parent Experience of Pediatric Care - PECP), and the second part concerns the general socio-demographic data of the parent/guardian. Statistical evaluation was performed using appropriate statistical programs (Statistics for Windows 7,0 and SPSS 17.0). Results: In accordance with the age of the parents, the survey respondents were divided into two groups: a) age ≤ 33 years - 107 (51.69%) and b) age> 33 years - 100 (48.31%).Significant independent predictor of parental satisfaction from the receipt of their child to the clinic research confirms the age of the parent under / over 33 years due to 4.1% of the change in satisfaction (R2 = 0,041). Parents generally believe that their children's room of the clinic is "good", without significant difference between parental satisfaction from both age groups (Mann-Whitney U Test Z = -0,9613 p = 0,3364). Significant independent predictor of parental satisfaction from the room of their child improves the health status after treatment due to 6% of the change in satisfaction (R2 = 0,060). Parents generally believe that testing and treatment of their children in the clinic was "very good" and an independent significant predictor is to improve the health status after the treatment - 7,8% (R2 = 0,078). Conclusions: Regardless of the generally good parental satisfaction about health care for their children, it is necessary to continuously monitor the status of the clinic in order to consider the possible deficiencies and needs of intervention.


2020 ◽  
pp. 1-9
Author(s):  
Alessandro de Sire ◽  
Marco Invernizzi ◽  
Martina Ferrillo ◽  
Francesca Gimigliano ◽  
Alessio Baricich ◽  
...  

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p <  0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuchen Ying ◽  
Liemin Ruan ◽  
Fanqian Kong ◽  
Binbin Zhu ◽  
Yunxin Ji ◽  
...  

An amendment to this paper has been published and can be accessed via the original article.


2011 ◽  
Vol 18 (03) ◽  
pp. 518-524
Author(s):  
GHULAM SARWAR ◽  
FARIDA MANZUR ◽  
IMTIAZ HAMID

Objectives: (1) To determine the mode of services being rendered and practices done by the health care providers of the study area. (2) To identify various socio-demographic factors about the health care providers. A health care provider provides preventive, curative, rehabilitative and spiritual health services to the community. Health care is being provided by not only the registered and qualified doctors, but also by non-qualified non-registered and inexperienced persons in Pakistan. Methodology: A total of 57 health care providers from the union council 42 area in district Faisalabad were included. A pre-tested questionnaire to know about the services and practices of the individuals was served upon them to collect the relevant data. Design: Cross-sectional study. Setting: Union council 42 area in district Faisalabad. Period: 2008. Results: Out of 57, 30 (52.63%) were males and 27 (47.37%) were females. Most of them, 18 (31.6%) were above 49 years of age. 51 (89.47%) were practicing in the private; whereas, only 2(3.51%) in the public sector. Most of the individuals, 21 (36.8%) were LHW and only 2(3.5%) were doctors or medical assistants; 3(5.3%) were dispensers, 9(15.8%) were hakeems and 7 (12.3%) homeopaths. Most of them, 40(70.2%) were matriculates and 14(24.6%) graduates. Only 20 (35.1%) were having certificates and 11(19.3%) were diploma holders. Further, only 2(11.76%) out of 57 were registered with PM&DC and Punjab Medical Faculty. 30 (52.6%) individuals were rendering curative and only 5 (8.8%) preventive services. None of the health care providers was rendering laboratory, x-ray or ultrasound services. Most of the individuals, 36 (63.2%) were practicing allopathy and 7(12.3%) homeopathy way of treatment. Further, most of the professionals, 45 (78.95%) were not doing any surgery. As regards sterilization, the most 8(66.7%) were practicing boiling of instruments. Most of them 47 (82.45%) were giving injections to the patients, however, using disposable syringes, and 27(57.4%) were disposing of the syringes by cutting the needles to dump. 20 (42.55%) were referring their patients to DHQ Hospital and 47 (82.46%) were keeping the record. Conclusions: Qualified medical professionals were scarce in the locality. However, allopathic system of medicine was being widely practiced. Only LHWs were providing curative services with proper training to deliver first aid services.


2020 ◽  
Vol 37 (5) ◽  
pp. 661-667
Author(s):  
Harry Cross ◽  
Carrie D Llewellyn

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.


2019 ◽  
Vol 54 (3) ◽  
pp. 334-344 ◽  
Author(s):  
Emma A Nye ◽  
Ashley Crossway ◽  
Sean M. Rogers ◽  
Kenneth E. Games ◽  
Lindsey E. Eberman

Context Research suggests that patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at risk for certain conditions and denied equal access to health care in physician offices compared with their heterosexual counterparts. However, little evidence exists regarding the treatment of LGBTQ student-athlete patients in the athletic training clinic and the role the athletic trainer (AT) plays in these health care experiences. Objective To explore the perceptions of ATs treating LGBTQ student-athlete patients. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A total of 1077 collegiate and university ATs completed the survey (5685 e-mails distributed, 1214 surveys started, access rate = 21.4%, completion rate = 88.7%). Main Outcome Measure(s) Demographic information and level of agreement in 3 areas (approach, quality of care, and comfort) were obtained on a 5-point Likert scale. We asked ATs their likeliness of providing guidance to student-athletes about navigating their sexuality generally and as it related to athletic participation, if they thought they provided equal health care to a student-athlete who identified as LGBTQ, how comfortable they were treating LGBTQ student-athlete patients, and how comfortable they thought student-athlete patients would be seeking care from them or from providers in their clinic. Results Overall, we found differences among groups for sexual orientation, gender, religion, and the existence of interpersonal contact with LGBTQ friends or family for approach, quality of care, and comfort. We also identified 2 main themes indicating ATs' desire for more training and education, specifically in caring for transgender student-athletes and providing patient-centered care with professionalism, regardless of gender identity or sexual orientation. Conclusions Although differences existed among demographic groups, ATs had a generally positive view of treating LGBTQ student-athlete patients and wanted more training and education on the specific needs of this population.


2019 ◽  
Vol 13 (1) ◽  
pp. 005
Author(s):  
Oluwabunmi Ogungbe ◽  
Amal K Mitra ◽  
Joni K Roberts

Background and objectives: Health disparities are a growing concern in health care. Research provides ample evidence of bias in patient care and mistrust between patient and providers in ways that could perpetuate health care disparities. This study aimed to review existing literature on implicit bias (or unconscious bias) in healthcare settings and determine studies that have considered adverse effects of bias of more than one domain of social identity (e.g., race and gender bias) in health care. Methods: This is a systematic review of articles using databases such as EBSCO, Embase, CINAHL, COCHRANE, Google Scholar, PsychINFO, Pub Med, and Web of Science. Search terms included implicit bias, unconscious bias, healthcare, and public health. The inclusion criteria included studies that assessed implicit bias in a healthcare setting, written in English, and published from 1997-2018. Results: Thirty-five articles met the selection criteria – 15 of which examined race implicit bias, ten examined weight bias, four assessed race and social class, two examined sexual orientation, two focused on mental illness, one measured race and sexual orientation, and another investigated age bias. Conclusions: Studies that measured more than one domain of social identity of an individual did so separately without investigating how the domains overlapped. Implicit Association Test (IAT) is a widely used psychological test which is used to determine existence of an implicit bias in an individual. However, this study did not find any use of an instrument that could assess implicit bias toward multiple domains of social identities. Because of possible multiplicative effects of several biases affecting a single entity, this study suggests the importance of developing a tool in measuring intersectionality of biases. IMC J Med Sci 2019; 13(1): 005


Author(s):  
Jinzhu Xie ◽  
Yinhuan Hu ◽  
Chuntao Lu ◽  
Qiang Fu ◽  
Jason T. Carbone ◽  
...  

Hospitals are struggling to involve patients and learn from their experience. The risk factor of patient experience is increasingly recognized as a critical component in improving patient experience. Our study explored risk factors of negative patient experience in order to improve the health-service quality of public hospitals. We conducted a cross-sectional study in Hubei province, China. A total of 583 respondents were surveyed by the Outpatient Experience Questionnaire with good validity and reliability in July 2015. T-tests were conducted to compare the experience scores among different outpatient groups. Multiple linear regression was performed to determine the significant factors that influenced the outpatient experience. Outpatients between 18 and 44 years old had the lowest experience scores (65.89 ± 0.79), whereas outpatients completely paying out-of-pocket had the lowest experience scores (64.68 ± 0.81) among all participants. Outpatients with poor self-rated health status had the lowest experience scores (66.14 ± 1.61) among different self-rated health status groups. While age, type of payment, and self-rated health status were significantly risk factors that influenced outpatient experience in the multiple linear regression. Thus, health-care providers should pay more attention to outpatients who are young (age <45), completely out-of-pocket and poor health status, and provide precision health care to improve outpatient experience.


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