Access of Migrant Youths in Sweden to Sexual and Reproductive Healthcare: A Cross-sectional Survey

Background: This study aims to assess migrant youths’ access to sexual and reproductive healthcare (SRHC) in Sweden, to examine the socioeconomic differences in their access, and to explore the reasons behind not seeking SRHC. Methods: A cross-sectional survey was conducted for 1739 migrant youths 16 to 29 years-old during 2018. The survey was self-administered through: ordinary post, web survey and visits to schools and other venues. We measured access as a 4-stage process including: healthcare needs, perception of needs, utilisation of services and met needs. Results: Migrant youths faced difficulties in accessing SRHC services. Around 30% of the participants needed SRHC last year, but only one-third of them fulfilled their needs. Men and women had the same need (27.4% of men [95% CI: 24.2, 30.7] vs. 32.7% of women [95% CI: 28.2, 37.1]), but men faced more difficulties in access. Those who did not categorise themselves as men or women (50.9% [95% CI: 34.0, 67.9]), born in South Asia (SA) (39% [95% CI: 31.7, 46.4]), were waiting for residence permit (45.1% [95% CI: 36.2, 54.0]) or experienced economic stress (34.5% [95% CI: 30.7, 38.3]) had a greater need and found more difficulties in access. The main difficulties were in the step between the perception of needs and utilisation of services. The most commonly reported reasons for refraining from seeking SRHC were the lack of knowledge about the Swedish health system and available SRHC services (23%), long waiting times (7.8%), language difficulties (7.4%) and unable to afford the costs (6.4%). Conclusion: There is an urgent need to improve migrant youths’ access to SRHC in Sweden. Interventions could include: increasing migrant youths’ knowledge about their rights and the available SRHC services; improving the acceptability and cultural responsiveness of available services, especially youth clinics; and improving the quality of language assistance services.

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Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

SAGE Open Medicine ◽

10.1177/2050312120946215 ◽

2020 ◽

Vol 8 ◽

pp. 205031212094621

Author(s):

Afsaneh Bjorvatn ◽

Anne-Mette Magnussen ◽

Lisa Wallander

Keyword(s):

Medical Condition ◽

Waiting Times ◽

Legal Regulation ◽

General Level ◽

Legal Regulations ◽

Cross Sectional Survey ◽

Severe Condition ◽

Minor Variation ◽

Cross Sectional ◽

Specialist Treatment

Objective: This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.

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Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive?

BMJ Open ◽

10.1136/bmjopen-2018-028186 ◽

2019 ◽

Vol 9 (10) ◽

pp. e028186

Author(s):

Nachiappan Chockalingam ◽

Nicola Eddison ◽

Aoife Healy

Keyword(s):

Outcome Measures ◽

Service Provision ◽

Response Rate ◽

Waiting Times ◽

Lead Times ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Uk

ObjectiveTo investigate the quantity and quality of orthotic service provision within the UK.DesignCross-sectional survey obtained through freedom of information request in 2017.SettingNational Health Service (NHS) Trusts/Health Boards (HBs) across the UK.Main outcome measuresDescriptive statistics of survey results, including information related to finance, volume of appointments, patients and orthotic products, waiting times, staffing, complaints, outcome measures and key performance indicators.ResultsResponses were received from 61% (119/196) of contacted Trusts/HBs; 86% response rate from Scotland (12/14) and Wales (6/7), 60% (3/5) from Northern Ireland and 58% (98/170) from England. An inhouse service was provided by 32% (35/110) of responses and 68% (74/110) were funded by a block contract. Long waiting times for appointments and lead times for footwear/orthoses, and large variations in patient entitlements for orthotic products across Trusts/HBs were evident. Variations in the length of appointment times were also evident between regions of the UK and between contracted and inhouse services, with all appointment times relatively short. There was evidence of improvements in service provision; ability for direct general practitioner referral and orthotic services included within multidisciplinary clinics. However, this was not found in all Trusts/HBs.ConclusionsThe aim to provide a complete UK picture of orthotic service provision was hindered by the low response rate and limited information provided in some responses, with greater ability of Trusts/HBs to answer questions related to quantity of service than those that reflect quality. However, results highlight the large discrepancies in service provision between Trusts/HBs, the gaps in data capture and the need for the UK NHS to establish appropriate processes to record the quantity and quality of orthotic service provision. In addition to standardising appointment times across the NHS, guidelines on product entitlements for patients and their lead times should be prescribed to promote equity.

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THE SOCIAL PSYCHOLOGY OF CREATIVITY AND INNOVATION: PROCESS THEORY (PT) PERSPECTIVE

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2007.35.7.875 ◽

2007 ◽

Vol 35 (7) ◽

pp. 875-888 ◽

Cited By ~ 5

Author(s):

Li-Min Chuang

Keyword(s):

Process Model ◽

Service Industry ◽

Organizational Innovation ◽

Innovation Process ◽

Field Studies ◽

Process Theory ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Social ◽

Stage Process

The sources, stages, and processes of organizational innovation in some of Taiwan's benchmarking companies in the service industry are discussed. Process-theory-based research methodology was used to analyze the characteristics of the innovation process to achieve a better understanding of how and why innovations emerged, developed, grew, and terminated. The stage/process model was used to investigate organizational innovation (OI) processes and factors which affected processes. Conclusions were obtained chiefly through in-depth field studies and a retrospective cross-sectional survey. Amabile's (1988) model was modified to account for differences between practices and theories. The research resulted in an organizational innovation process model that was divided into five stages, just as in Amabile's model; on the other hand, Amabile's (1988) model was modified to account for differences between practice and theory during this study. The conclusions of this research may serve to broaden various perspectives of debate about individual, organizational, and environmental factors.

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Assessing a national policy on strengthening chronic care in primary care settings of a low-resource country using patients' perspectives.

10.21203/rs.3.rs-57447/v1 ◽

2020 ◽

Author(s):

Paibul Suriyawongpaisal ◽

Wichai Aekplakorn ◽

Samrit Srithamrongsaw ◽

Phanuwich Kaewkamjonchai

Keyword(s):

Primary Care ◽

Chronic Care ◽

Care Quality ◽

Local Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Mixed Effect ◽

Multiprofessional Team ◽

Primary Care Settings ◽

Healthcare Needs

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model(CCM). This study conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 25 primary care units and 16 hospital NCD clinics in 11 provinces (76 in total) to examine the effects of provider training and local health systems settings on patients’ perception of the chronic care quality.Methods A home-based interview with questionnaire was conducted on the patients in primary care settings. The questionnaire was adopted from the Thai version of the Patient Assessment of Chronic Illness Care (PACIC+) developed by the MacColl Institute for Healthcare Innovation. The questionnaire contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model.Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics. Upgraded PCUs were ordinary PCUs with the multiprofessional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input.Results Mixed effect models depicted an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.52-1.76; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.66-1.87; p<0.05) or having phone contacts of the providers (ORs:1.42-1.63; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.4-2.0 times compared to those for patients attending hospital NCD clinics(p<0.05). Conclusions We could not find evidence to support effectiveness of the training approach. The training failure might indicate a need to address mismatch between health workforce and workload. It also indicates a need to incorporate fidelity check into any training program for chronic care addressing the complex healthcare needs.

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Prevalence of Age-Related Lens Opacities in a Population

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0005 ◽

2020 ◽

pp. 27-32

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

The United States ◽

Population Based ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Healthcare Needs ◽

Age Related ◽

Beaver Dam ◽

Level 3 ◽

Study Population ◽

Lens Opacities

The Beaver Dam Eye Study was a population-based cross-sectional survey designed to estimate the prevalence and severity of lens opacities in a rural community in the United States. Prior to this survey there were no reliable estimates of the prevalence and severity of lens opacities. The survey found that lens opacities were common in adults, and the numbers were increasing as the population aged. Overall, 17.3% of the study population had nuclear sclerosis more severe than level 3 in a 5-step scale of severity; cortical opacities were found in 16.3%; and posterior subcapsular opacities occurred in 6.0% of the population. The study emphasized the importance of such data for providing for social and healthcare needs and planning for future services.

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Estimate dynamic changes of dysfunction and lifelong spent for psychiatric care needs in patients with schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2018.07.009 ◽

2018 ◽

Vol 54 ◽

pp. 65-70 ◽

Cited By ~ 3

Author(s):

Chien-Chou Su ◽

Ya Mei Bai ◽

Ming-Hui Chou ◽

Jung-Der Wang ◽

Yen Kuang Yang

Keyword(s):

Social Relationships ◽

Dynamic Change ◽

Average Lifetime ◽

Care Needs ◽

Cross Sectional Survey ◽

Primary Analysis ◽

Global Functioning ◽

Dynamic Changes ◽

Cross Sectional ◽

Healthcare Needs

AbstractBackground:Disturbance of functionality is one of the core features of schizophrenia, and has deleterious effects on a patient’s employment, increased healthcare costs, and a large societal burden. Thus, if a patient’s disability status could be predicted, and interventions needed identified in advance, poor outcomes could be prevented. To achieve this aim, we developed a method by which to assess dynamic changes of dysfunction and estimate the lifetime duration of disability in patients with schizophrenia, as a proxy for assessing their specialized healthcare needs.Methods:The proposed method was developed based on a nationwide database and a cross-sectional survey. The primary analysis investigated the dynamic change in the proportion of patients with manifested disability over time, while the secondary analysis estimated the lifetime duration of disability, obtained as the proportion of patients with manifested disability multiplied by the survival probability throughout the life of patients.Results:The average lifetime duration of manifested disability of global functioning was estimated to be 20.9 years, which represents approximately 73% of the whole lifetime of patients. The duration of disability in socially-useful activities was estimated to be 15.6 years, while that in personal and social relationships was 17.5 years. The female patients had a longer duration of manifested disability (22.9 years) than the male patients (19.5 years).Conclusions:The developed method of analysis indicated that the longest lifetime durations of manifest disability were observed in the areas of socially-useful activities and personal and social relationships, and the proportions of patients with these disabilities rapidly increased at 200 months after diagnosis.

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Women’s experiences of mistreatment during childbirth and their satisfaction with care: findings from a multicountry community-based study in four countries

BMJ Global Health ◽

10.1136/bmjgh-2020-003688 ◽

2021 ◽

Vol 5 (Suppl 2) ◽

pp. e003688

Author(s):

Thae Maung Maung ◽

Nwe Oo Mon ◽

Hedieh Mehrtash ◽

Kwame Adu Bonsaffoh ◽

Joshua P Vogel ◽

...

Keyword(s):

Waiting Times ◽

Secondary Analysis ◽

Verbal Abuse ◽

Satisfaction With Care ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Women’S Experiences ◽

Women's Experiences ◽

Assess Quality

IntroductionExperiences of care and satisfaction are intrinsically linked, as user’s experiences of care may directly impact satisfaction, or indirectly impact user’s expectations and values. Both experiences of care and satisfaction are important to measure so that quality can be monitored and improved. Globally, women experience mistreatment during childbirth at facilities; however, there is limited evidence exploring the mistreatment and women’s satisfaction with care during childbirth.MethodsThis is a secondary analysis of a cross-sectional survey within the WHO study ‘How women are treated during facility-based childbirth’ exploring the mistreatment of women during childbirth in Ghana, Guinea, Myanmar and Nigeria. Women’s experiences of mistreatment and satisfaction with care during childbirth was explored. Multivariable logistic regression modelling was conducted to evaluate the association between mistreatment, women’s overall satisfaction with the care they received, and whether they would recommend the facility to others.Results2672 women were included in this analysis. Despite over one-third of women reporting experience of mistreatment (35.4%), overall satisfaction for services received and recommendation of the facility to others was high, 88.4% and 90%, respectively. Women who reported experiences of mistreatment were more likely to report lower satisfaction with care: women were more likely to be satisfied if they did not experience verbal abuse (adjusted OR (AOR) 4.52, 95% CI 3.50 to 5.85), or had short waiting times (AOR 5.12, 95% CI 3.94 to 6.65). Women who did not experience any physical or verbal abuse or discrimination were more likely to recommend the facility to others (AOR 3.89, 95% CI 2.98 to 5.06).ConclusionMeasuring both women’s experiences and their satisfaction with care are critical to assess quality and provide actionable evidence for quality improvement. These measures can enable health systems to identify and respond to root causes contributing to measures of satisfaction.

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Social Factors Associated with Trust in the Health System in Northern Sweden: A Cross-Sectional Study

10.21203/rs.3.rs-701308/v1 ◽

2021 ◽

Author(s):

Mazen Baroudi ◽

Isabel Goicolea ◽

Anna-Karin Hurtig ◽

Miguel San-Sebastian

Keyword(s):

Social Capital ◽

Health System ◽

Strong Relationship ◽

Sociodemographic Factors ◽

Economic Stress ◽

Lower Prevalence ◽

Northern Sweden ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated

Abstract Background Despite the importance of having trust in the health system, there is a paucity of research in this field in Sweden. The aim of this study was to estimate the level of trust in the health system and to assess the factors associated with it in northern Sweden. Methods A cross-sectional survey was conducted in 2014 in the four northern regions of Sweden. A total of 24 795 participants aged 18 to 84 years were involved in the study. A log-binomial regression was used to measure the association between sociodemographic factors and trust in the health system. Results Two thirds of the participants (68.5%) reported high trust in the health system. Women had lower prevalence of trust compared to men (PR = 0.96; 95% CI = 0.94–0.98) while older participants had a higher trust compared to youth (PR = 1.11; 95% CI = 1.06–1.16). Participants with lower level of education, those who experienced economic stress, those who were born outside Sweden and those living in small municipalities also had lower prevalence of trust in the health system. Conversely, lower income was associated with higher trust (PR = 1.08; 95% CI = 1.04–1.12). Finally, a strong relationship between social capital and trust in the health system was also found. Conclusions Trust in the health system was moderately high in northern Sweden and strongly associated with sociodemographic and social capital factors. Trust is a complex phenomenon and a deeper exploration of the relation between trust in the health system and sociodemographic factors is needed.

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Budding nurses readiness for clinical practice: the future is now

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195910 ◽

2019 ◽

Vol 8 (1) ◽

pp. 215

Author(s):

Vivanjeet Kaur ◽

Varsha Dhama ◽

Karamjeet Kaur ◽

Malar Kodi S. ◽

Rashmi Rawat

Keyword(s):

Nursing Education ◽

Clinical Practice ◽

Nursing Students ◽

Demographic Data ◽

Clinical Settings ◽

Care Needs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Healthcare Needs ◽

Graduate Nursing

Background: Freshly registered nurses’ experience of conversion from student to skilled professionals calls for making significant adjustments to shifting personal and professional roles at the beginning of their career as a nurse. Nursing education is aimed to help students to become beginning practitioners in the field of nursing. This study was taken up to explore the perception of the outgoing nursing students about their readiness to work in the clinical settings after graduation. On completion of graduation, these budding practitioners are anticipated to adjust in the clinical settings rapidly and be proficient of providing innocuous care for patients with multifaceted care needs. It is expected from graduate nurses to be well equipped for clinical practice, but reality may be different and there could be numerous barriers associated with it.Methods: It was a descriptive cross-sectional survey. A total of 176 outgoing graduate nursing students were selected using total enumerative sampling from different colleges of state of Uttarakhand and were asked to complete a demographic data sheet and self- reported readiness to clinical practice questionnaire.Results: Results have shown that more than half of the outgoing graduate nursing students were not ready for clinical practice. Most of them recognized sleep disturbance, low salary, lack of time and documenting error as barrier for their readiness to clinical practice.Conclusions: The findings of the study show that 63.3% of outgoing graduate nursing students were not ready to work in clinical area which is a matter of concern with the rising healthcare needs and increasing demands of the consumers of health. The results call for a change in the working condition for the nursing staff and a raise in wages worth making them to opt for clinical practice.

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Attitudes and Intention to Work With Older Adults by USA and Israeli Nursing Students: Measure Adaptation and Testing

Innovation in Aging ◽

10.1093/geroni/igaa057.700 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 217-217

Author(s):

Catherine Van Son ◽

Anna Zisberg ◽

Ksenya Shulyaev

Keyword(s):

Older Adults ◽

Nursing Students ◽

Construct Validity ◽

Survey Design ◽

The United States ◽

Original Structure ◽

Validity And Reliability ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Healthcare Needs

Abstract More nurses are needed to meet the healthcare needs of older adults. Valid and reliable measures are lacking that assess attitudes and intentions of nursing students to select a career in geriatrics. This paper discusses the applicability of the Carolina Opinions on Care of Older Adults (COCOA) instrument on attitudes towards and intention to work with older adults among nursing students. A cross-sectional survey design was used with samples of nursing students from the United States (N=122) and Israel (N=109). Students completed the COCOA instrument and the measure’s dimensionality, construct validity, reliability and equivalence among the nursing students was tested. Exploratory Factor Analysis (EFA) produced 5 factors explaining 59% of the variation with most of the items (17, 71%) loading above 0.40 on subscales according to the instrument’s original structure. Four items loaded on different subscales than originally described. One original subscale was eliminated (Value of Older Adults), and one new subscale was created (Older versus Younger Adults). The reliability scores were good to acceptable for all subscales (.60 - .80). Confirmatory FA supported the data’s fit to the modified COCOA instrument (CMIN/DF=1.55, CFI=.93, IFI=.93, RMSEA=.05). The analysis of model equivalence for USA and Israeli samples revealed significant differences attributed to Experience in Caring for Older Adults subscale. The modified COCOA instrument demonstrated good construct validity and reliability and can serve as estimation of nursing students’ attitudes towards older adults and intention to choose geriatrics as a career. Further studies are needed to test its predictive validity.

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