Search results

Canada has a globally recognized universal health-care system. However, immigrants experience a number of obstacles in obtaining primary health care (PHC) that may differ within various communities due to the intersection of culture, gender and other identities. To date, no research has been done on the difficulties Nepalese immigrant women in Canada may face accessing PHC. The purpose of this study was to learn about their perceptions of barriers to PHC access and to share the findings with a wide range of stakeholders, including health-care providers and policymakers.

The authors conducted a community-engaged qualitative study in Calgary, Alberta, Canada. A total of six focus group discussions (FGD) among 34 participants (each FGD consisted of 5–7 participants) were conducted. The authors collected demographic information before each focus group. The FGDs were audio recorded and transcribed verbatim. The transcriptions were coded and analysed thematically.

The focus groups identified long wait times as a major barrier to receiving PHC services. Long wait times in emergency rooms, unable to see family doctors when they were sick, tedious referral procedures, long waits at the clinic even after scheduling an appointment, family responsibilities and work all impacted their access to PHC. Further, a lack of proficiency in English was another significant barrier that impeded effective communication between physicians and immigrant women patients, thus compromising the quality of care. Other barriers mentioned included lack of access to medical records for walk-in doctors, insufficient lab/diagnostic services, a lack of urgent care services and unfamiliarity with the Canadian health-care system.

Accessible PHC is essential for the health of immigrant populations in Canada. This study recognizes the extent of the barriers among a relatively less studied immigrant population group, Nepalese immigrant women, which will help effectively shape public policy and improve access to PHC for the versatile immigrant population fabric in Canada.

High quality health-care delivery is not only the governments’ responsibility but also every prisoner’s right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers’ perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons.

A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data.

The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes).

Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process.

This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals in primary and secondary health care in Punjab, Pakistan. This study aims to report on the barriers to accessing and using online health-care information from rural settings of the Punjab province of Pakistan.

A cross-sectional survey was conducted in primary and secondary health-care settings in the Punjab province of Pakistan. The study’s population consisted of the rural primary care physicians (PCPs), who were geographically dispersed across 2,873 different remote health-care settings across Punjab. These practice settings included 2,455 basic health units, 293 rural health centers, 89 tehsil headquarter hospitals and 36 district headquarter hospitals.

Limited internet access, non-availability of required equipment and lack of training facilities were identified as the main barriers. PCPs’ gender, previous enrollment in post-graduation programs and type of health-care facility were significant factors in the perceived barriers related to both “non-availability of required equipment” and “inadequate training facilities on the use of information resources”.

The findings of the study hold some important practical implications for different stakeholders. This study identifies and addresses the barriers to accessing and using health-care information for PCPs in rural settings. The success of the health-care information outreach program in Punjab, Pakistan, should rely on the eradication of these barriers.

To the best of the authors’ knowledge, this is the first large-scale study in Pakistan that assesses the barriers and proposes ways to overcome these barriers to effectively access and use health-care information.

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States.

Data were derived from 13 semistructured focus groups, plus three semistructured interviews, and were analyzed inductively consistent with a grounded theory approach.

Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, nonphysician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers.

Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power.

This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

The objectives of the current interim report are to measure the extent of the access to care problem, identify and compare the types of patient- and system-based barriers experienced by Vietnam veterans at risk for suicide when seeking care for physical, psychiatric, and substance abuse conditions, analyze patient-perceived quality of care for individuals who obtained access to care, and identify how the care-seeking experience effected future care seeking. This study is based on a longitudinal sample of 494 Vietnam veterans discharged from military service in September 1971 and subsequently identified as at risk for suicide (306 low risk; 188 high risk). Seventy-one percent (350) of 494 participants completed an extensive qualitative and quantitative interview covering, among other topics, physical conditions, psychiatric conditions, substance use, barriers to care, facilitators of care, and quality of care. Barriers, satisfaction, and effect of the experience were compared by type of condition and suicidal risk category using χ2 analysis and Fisher's as appropriate. The analysis is based on 257 interviews (73 percent) with qualitative data transcribed thus far. Results: Of the 195 patients with self-reported health conditions, 76 (39.0 percent) and 45 (23.1 percent) expressed system-based barriers to care, respectively. The group at higher risk of suicide was significantly more likely (p<0.01) to report patient-based barriers to care and system-based barriers to care (p<0.05), and more likely (p<0.05) to experience negative effects of the care-seeking experience. Both self-perceived and system-based barriers to care pose obstacles for patients at high risk of suicide. Targeted interventions are required to reach out to these patients to address needs for care currently unmet by the health care system and to reduce negative effects of the health care experience.

In light of the growing number of refugees and immigrants in Canada, this paper aims to identify barriers to mental health services for newcomer immigrants and refugees in Quebec and to examine how mental health services can be improved for these populations.

In this qualitative study, semi-structured individual interviews with Farsi-speaking health professionals and focus group interviews with participants from community organizations in Quebec were conducted.

Participants, both health-care professionals and community members, reported that mental health services are not readily accessible to Farsi-speaking immigrants and refugees. Structural barriers, language barriers, cultural safety and stigma were identified as obstacles to accessing care. Recommended strategies for improving access to mental health care are discussed.

Multiple studies have found that language and cultural barriers are associated with health inequalities and under-utilization of mental health services among linguistic and ethnic minorities. However, there are limited data on many groups and contexts, and a need to better understand how language barriers affect health outcomes, service utilization, patient satisfaction or overall costs to the health system or to society. In response to this gap, the present study explores how access to mental health services for Farsi-speaking newcomers may be limited by structural and linguistic barriers and cultural differences and as well as to identify strategies that can reduce the identified barriers.

Compte tenu du nombre croissant de réfugiés et d'immigrants au Canada, cette étude vise à identifier les obstacles aux services de santé mentale pour les nouveaux arrivants immigrants et réfugiés au Québec et à examiner comment les services de santé mentale peuvent être améliorés pour ces populations.

Dans cette étude qualitative, des entretiens individuels semi-structurés avec professionnels de la santé parlant le Farsi et entretiens avec des participants des organisations communautaires au Québec ont été menées.

Les participants, tant des professionnels de la santé que des membres de la communauté, ont déclaré que les services de santé mentale sont inaccessibles aux immigrants et réfugiés parlant le Farsi. Obstacles structurels, les barrières linguistiques, la sécurité culturelle et la stigmatisation ont été identifiées comme des obstacles à l'accès aux soins. Les stratégies recommandées pour améliorer l'accès aux soins de santé mentale sont discutées.

De nombreuses études ont montré que les barrières linguistiques et culturelles sont associées à les inégalités en matière de santé et la sous-utilisation des services de santé mentale chez les minorités linguistiques et ethniques. Cependant, les données sont limitées sur de nombreux groupes et contextes, et il est nécessaire de mieux comprendre comment les barrières linguistiques ont une incidence sur les résultats de santé, l'utilisation des services, la satisfaction des patients ou les coûts globaux pour le système de santé ou à la société. En réponse à cet écarte, la présente étude examine comment l'accès aux services de santé mentale pour les nouveaux arrivants parlant le farsi peuvent être limités par des barrières structurelles et linguistiques et des différences culturelles, ainsi que d'identifier les stratégies de réduire les obstacles identifiés.

The purpose of this study is to explore the role of continuous learning and the mitigation or elimination of knowledge barriers affecting information technology (IT) assimilation in the health-care sector. Most of the problems with IT assimilations stem from a poor understanding of the nature of suitable information, the lack of trust, cultural differences, the lack of appropriate training and hierarchical bureaucratic structures and procedures. To overcome these barriers, this study provides evidence that a continuous learning process can play a part in overcoming some of the obstacles to the assimilation of IT.

This study investigates how a continuous learning environment can counteract the presence of knowledge barriers, and, along with such an environment, can, in turn, facilitate IT assimilation. The study uses ADANCO 2.0.1 Professional for Windows and involves the collection and analysis of data provided by 210 health-care end users.

The study provides evidence in support of the proposition that continuous learning may facilitate the assimilation of IT by health-care end users through the mitigation of knowledge barriers (e.g. lack of trust or resistance to change). The mitigation of these barriers requires the gathering and utilization of new knowledge and knowledge structures. The results support the hypothesis that one way in which this can be achieved is through continuous learning (i.e. through assessing the situation, consulting experts, seeking feedback and tracking progress).

A limitation of the study is the relatively simple statistical method that has been used for the analysis. However, the results provided here will serve as a preliminary basis for more sophisticated analysis which is currently underway.

The study provides useful insights into ways of using continuous learning to facilitate IT assimilation by end users in the health-care domain. This can be of use to hospitals seeking to implement end user IT technologies and, in particular, telemedicine technologies. It can also be used to develop awareness of knowledge barriers and possible approaches to mitigate the effects of such barriers. Such an awareness can assist hospital staff in finding creative solutions for using technology tools. This potentially augments the ability of hospital staff to work with patients and carers, encouraging them to take initiative (make choices and solve problems relevant to them). This, in turn, allows hospitals to avoid negative and thus de-motivating experiences involving themselves and their end users (patients) and improving IT assimilation. This is liable to lead to improved morale and improved assimilation of IT by end users (patients).

As ICT systems and services should entail participation of a wide range of users, developers and stakeholders, including medical doctors, nurses, social workers, patients and programmers and interaction designers, the study provides useful social implication for health management and people well-being.

The paper contributes to a better understanding of the nature and impacts of continuous learning. Although previous studies in the field of knowledge management have shown that knowledge management procedures and routines can provide support to IT assimilation, few studies, if any, have explored the relationship between continuous learning and IT assimilation with particular emphasis on knowledge barriers in the health-care domain.

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen interviews were conducted with special attention to the quality and quantity of health and mental health care services veterans accessed, the barriers and local contextual factors in accessing and utilizing services, and potential solutions to service gaps for women veterans from two Montana reservations, the Northern Cheyenne Reservation and the Confederated Salish and Kootenai Tribes of the Flathead Reservation.

We examine the barriers and needs of Native American veterans in both reservations using qualitative methods. The research analyzed 18 interviews with women veterans from the Northern Cheyenne and Flathead reservations.

Native American women veterans identified a number of barriers to accessing care, some of which include lack of information regarding eligibility and the types of services available. Women often found the application process to be confusing and difficult. Other barriers included distance, cost of travel, and conflicts with their work schedule.

This exploratory case study served to clarify the challenges and obstacles Native American women veterans experience with accessing health and mental health services. This research revealed several patterns and themes in the experience of Native American women veterans in both reservation communities when attempting to access and seek care at Veterans Administration (VA) facilities and Indian Health Services (IHS). This research calls for policy changes and research to clarify how resources can be more efficiently and effectively distributed to rural veterans.

Little research has addressed the needs of Native American veterans. American Indians and Alaska Natives serve at a higher rate in the U.S. military than any other population. This research provides important information about Native American veterans who are often underrepresented in survey research, yet a rapidly growing segment of the United States military and veteran population.

This study examined 46 articles in total, which yielded 5 recurring themes: perceived discrimination, language barriers, socioeconomic barriers, cultural barriers and educational/knowledge barriers. The two most dominant themes found were the inability to speak the country's primary language and belonging to a culture with different practices and values from the host country. The review provides vital insights into the numerous challenges that immigrants and refugees encounter as they navigate through the primary care systems of English-speaking (E-S) countries and potential solutions to overcome these barriers.

Access to adequate healthcare plays a central part in ensuring the physical and mental wellbeing of society. However, vulnerable groups such as immigrants and refugees, face numerous challenges when utilizing these healthcare services. To shed further light on the barriers impacting healthcare quality, the authors’ team performed a scoping thematic review of the available literature on immigrant and refugees' experiences in primary healthcare systems across E-S countries. Articles were systematically reviewed while focusing on healthcare perceptions by immigrants, potential barriers and suggestions to improve the quality of primary care.

This work looked at qualitative and quantitative information, attempting to combine both paradigms to give a rich and robust platform with which to devise a further study through focus groups. Qualitative inquiry accounted for 28/46, or 61%, of studies, and quantitative inquiry made up 9/46, or 20%, while 9/46 or 20% combined both qualitative and qualitative. Emerging themes are -perceived ethnic discrimination faced by immigrants accessing primary care, language barriers, socioeconomic barriers, cultural barriers and educational barriers.

Most medical journals rely on quantitative data to relate “results” and cases. The authors set out to change ways in which medical reports can be done. Most of the authors were solely trained in quantitative research; consequently, they had to learn to isolate themes and to use a narrative approach in the article.

Research implications clearly indicated that using a qualitative (phenomenological) approach with quantitative data created a human and reachable discourse around patient comfort and the realities of immigrants and refugees to E-S countries. The use of this research opens medical practitioners (and patients) to a richer understanding within a usually difficult arena.

By understanding the qualitative nature of medical research, practitioners, students and mentors are able to bridge medical quantitivity to the human, widening doors to social science and medical collaboratory research.

As stated above, this work is important as it understands the human/patient element and de-emphasizes the medical obsession with quantifying the lives of patients through hard data. This is a unique collaboration that relies on the qualitative to pinpoint and define the difficulties of newcomers to E-S countries.

The universality of the health system in Canada is often emphasised to contrast the differences between the Canadian and American systems of access to care. However, changes in migration patterns and tightening of administrative procedures around undocumented persons are beginning to challenge this Canadian image. Currently, there is a lack of data to support the existence and the consequences of this shift. This pilot project documents health care professionals' and community organisation workers' perceptions of the problems faced by recent migrants in accessing health care, and the health consequences of such barriers. Results confirm the existence of numerous health care access problems for both completely undocumented migrants and legal migrants who fall into the cracks of the provincial and federal health systems. The data suggests that these barriers may have important unrecognised morbidity and mortality consequences, and that they are a source of severe stress and psychological distress. To protect recent immigrant families, there is a need not only to revise the articulation between the provincial and federal health mandates but also to address the strong societal perception linking universality of health care to the notion of citizenship. Further research is warranted on this emerging social problem, but the institutional sensitivity of these issues may constitute an obstacle to a more comprehensive understanding.