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21 – 30 of over 3000Peter Nugus, Joanne Travaglia, Maureen MacGinley, Deborah Colliver, Maud Mazaniello-Chezol, Fernanda Claudio and Lerona Dana Lewis
Researchers often debate health service structure. Understanding of the practical implications of this debate is often limited by researchers' neglect to integrate participants'…
Abstract
Purpose
Researchers often debate health service structure. Understanding of the practical implications of this debate is often limited by researchers' neglect to integrate participants' views on structural options with discourses those views represent. As a case study, this paper aims to discern the extent to which and how conceptual underpinnings of stakeholder views on women's health contextualize different positions in the debate over the ideal structure of health services.
Design/methodology/approach
The researchers chose a self-standing, comprehensive women's health service facing the prospect of being dispersed into “mainstream” health services. The researchers gathered perspectives of 53 professional and consumer stakeholders in ten focus groups and seven semi-structured interviews, analyzed through inductive thematic analysis.
Findings
“Women's marginalization” was the core theme of the debate over structure. The authors found clear patterns between views on the function of women's health services, women's health needs, ideal client group, ideal health service structure and particular feminist discourses. The desire to re-organize services into separate mainstream units reflected a liberal feminist discourse, conceiving marginalization as explicit demonstration of its effects, such as domestic abuse. The desire to maintain a comprehensive women's health service variously reflected post-structural feminism's emphasis on plurality of identities, and a radical feminist discourse, holding that womanhood itself constituted a category of marginalization – that is, merely being at risk of unmet health needs.
Originality/value
As a contribution to health organizational theory, the paper shows that the discernment of discursive underpinnings of particular stakeholder views can clarify options for the structure of health services.
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Salma El-Gamal and Johanna Hanefeld
The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and…
Abstract
Purpose
The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and requisite adjustments to policy addressing the new needs of the migrant population. This study aims to examine and compare policies for access to health care and the related health outcomes for refugees and asylum-seekers settling both in the UK and Germany as host countries.
Design/methodology/approach
The paper conducted a scoping review of academic databases and grey literature for studies within the period 2010-2017, seeking to identify evidence from current policies and service provision for refugees and asylum-seekers in Germany and the UK, distilling the best practice and clarifying gaps in knowledge, to determine implications for policy.
Findings
Analysis reveals that legal entitlements for refugees and asylum-seekers allow access to primary and secondary health care free of charge in the UK versus a more restrictive policy of access limited to acute and emergency care during the first 15 months of resettlements in Germany. In both countries, many factors hinder the access of this group to normal health care from legal status, procedural hurdles and lingual and cultural barriers. Refugees and asylum-seeker populations were reported with poor general health condition, lower rates of utilization of health services and noticeable reliance on non-governmental organizations.
Originality/value
This paper helps to fulfill the need for an extensive research required to help decision makers in host countries to adjust health systems towards reducing health disparities and inequalities among refugees and asylum-seekers.
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Sarah Longstaff, Jeni Rees, Elizabeth Good and Elizabeth Kirby
In a novel approach, two part-time “Link Nurses” within an NE Hampshire practice of 16,500 patients were funded by a local charity, to assess and manage unmet needs of isolated…
Abstract
Purpose
In a novel approach, two part-time “Link Nurses” within an NE Hampshire practice of 16,500 patients were funded by a local charity, to assess and manage unmet needs of isolated frail elderly patients at home. The paper aims to discuss these issues.
Design/methodology/approach
Patients in this vulnerable group with no recorded healthcare contact for a prolonged period were identified from practice computer records. One group was to be assessed at home, and appropriate interventions effected. Follow-up visits or telephone contacts also offered support to carers as well as isolated individuals. A matching quasi control group was identified but not visited, to assess the overall impact on the patients, GP and other healthcare contacts. Difficulties with the control group were encountered and addressed.
Findings
Important unmet healthcare needs were found amongst the visited patients, which the nurses were able to address themselves, or refer to the GPs or appropriate agencies. The control group demonstrated greater demand for out-of-hours, GP and district nurse contacts, and more unplanned hospital admissions.
Practical implications
Besides dealing with unmet needs at home, ongoing support by local GP nurses may reduce bed-blocking by moving away from “crisis management” of patients in this vulnerable group.
Originality/value
Few other trials have employed practice nurses to see and manage frail elderly patients in their homes.
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Abyshey Nhedzi, Sadiyya Haffejee, Michelle O'Reilly and Panos Vostanis
This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South…
Abstract
Purpose
This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa.
Design/methodology/approach
The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis.
Findings
Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working.
Practical implications
Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working.
Originality/value
Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.
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This study aims to explore the challenges in the Jordanian health-care system and the potential solutions for these challenges.
Abstract
Purpose
This study aims to explore the challenges in the Jordanian health-care system and the potential solutions for these challenges.
Design/methodology/approach
A narrative literature review was conducted.
Findings
The challenges of the health-care system in Jordan related to geriatric care are the new emergence of nursing homes; the limited health-care services and supplies; the growing aging population; the dramatic change in the family structure. There are many credible approaches used to solve those challenges, including social networking, advocacy, education and research, lobbying and financial support.
Originality/value
There is a lack of research studies examining the perceived barriers and facilitators of geriatric care in Jordan from the perspectives of health-care professionals, health-care managers and older adults themselves. Future intervention studies are recommended to target the challenges in the Jordanian health-care system concerning geriatric care.
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Elizabeth S. Barnert, Laura S. Abrams, Lello Tesema, Rebecca Dudovitz, Bergen B. Nelson, Tumaini Coker, Eraka Bath, Christopher Biely, Ning Li and Paul J. Chung
Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper…
Abstract
Purpose
Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper aims to discuss this issue.
Design/methodology/approach
The authors analyzed data from 14,689 adult participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to compare adult health outcomes among those first incarcerated between 7 and 13 years of age (child incarceration); first incarcerated at>or=14 years of age; and never incarcerated.
Findings
Compared to the other two groups, those with a history of child incarceration were disproportionately black or Hispanic, male, and from lower socio-economic strata. Additionally, individuals incarcerated as children had worse adult health outcomes, including general health, functional limitations (climbing stairs), depressive symptoms, and suicidality, than those first incarcerated at older ages or never incarcerated.
Research limitations/implications
Despite the limitations of the secondary database analysis, these findings suggest that incarcerated children are an especially medically vulnerable population.
Practical implications
Programs and policies that address these medically vulnerable children’s health needs through comprehensive health and social services in place of, during, and/or after incarceration are needed.
Social implications
Meeting these unmet health and social service needs offers an important opportunity to achieve necessary health care and justice reform for children.
Originality/value
No prior studies have examined the longitudinal relationship between child incarceration and adult health outcomes.
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Ayden I. Scheim, Randy Jackson, Liz James, T. Sharp Dopler, Jake Pyne and Greta R. Bauer
Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse) people…
Abstract
Purpose
Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse) people. This paper aims to describe barriers to well-being in a sample of Aboriginal gender-diverse people in Ontario, Canada.
Design/methodology/approach
In 2009-2010, 433 trans people in Canada's most populous province participated in a multi-mode health survey. In all, 32 participants identified as First Nations, Métis, or Inuit (Aboriginal); unweighted frequencies were calculated to describe their characteristics.
Findings
Participants expressed diverse gender identities; 44 per cent identified with the pan-Aboriginal term two-spirit. High levels of poverty (47 per cent), homelessness or underhousing (34 per cent), and ever having to move due to being trans (67 per cent) were reported. In all, 61 per cent reported at least one past-year unmet health care need. Most participants had experienced violence due to being trans (73 per cent) and had ever seriously considered suicide (76 per cent). One-fifth had been incarcerated while presenting in their felt gender. Aboriginal spirituality was practiced by 44 per cent, and 19 per cent had seen an Aboriginal Elder for mental health support.
Research limitations/implications
Action is needed to address the social determinants of health among Aboriginal gender-diverse people. Using principles of self-determination, there is a need to increase access to health and community supports, including integration of traditional culture and healing practices. Larger study samples and qualitative research are required.
Originality/value
These first published data regarding the health of Aboriginal gender-diverse Ontarians illustrate both their heterogeneity and all-too-common experiences of individual and systemic discrimination, and barriers to care. Results highlight potential impacts of colonialism and social exclusion, and suggest priorities for ameliorative action.
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Marwa Halabi, Inaam Khalaf and Salam Bani Hani
This study aims to review the lived experience of patients suffering from stroke and describe their perception of palliative care needs.
Abstract
Purpose
This study aims to review the lived experience of patients suffering from stroke and describe their perception of palliative care needs.
Design/methodology/approach
A literature review search was conducted. Web of Sciences, SAGE, CINAHL, PubMed and Jordanian Database for Nursing Research databases were used to search the literature.
Findings
The findings of 37 articles were address palliative care approaches for patients with stroke, lived experiences of patients suffering from stroke and the experience, barriers and facilitators related to health-care service for stroke survivors.
Originality/value
This review indicated the importance of recognizing palliative care needs among patients suffering from stroke to improve post-stroke recovery. This study recommends further research, especially in low- and middle-income countries, to understand patients’ experiences and recognize the main palliative care needs that can be incorporated into interventions designed to improve the quality of life among them.
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Celia Harding and Julie Wright
This review explores some of the key issues relevant to children and adults who have dysphagia, or eating, drinking and swallowing difficulties, and a learning disability. It…
Abstract
This review explores some of the key issues relevant to children and adults who have dysphagia, or eating, drinking and swallowing difficulties, and a learning disability. It explores the methods for attempting to identify this area of difficulty effectively, and reflects on some of the other issues that may affect management, such as carer support and training and use of appropriate communication strategies to support and enable participation from the client with learning disability.
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Jonathan Michael and Anne Richardson
The Independent Inquiry into Access to Healthcare for People with Learning Disabilities reported in July 2008. Based on a public consultation, a review of research and evidence…
Abstract
The Independent Inquiry into Access to Healthcare for People with Learning Disabilities reported in July 2008. Based on a public consultation, a review of research and evidence and the views of witnesses and stakeholders, the Michael Inquiry concluded that there are risks inherent in the care system for people with learning disabilities and that they are largely due to a failure to make ‘reasonable adjustments’ to services, as required under the Disability Discrimination Act. The Inquiry found evidence of a significant level of avoidable suffering due to untreated ill‐health, and a high likelihood that avoidable deaths are occurring. Although the report highlights examples of good practice there are some appalling examples of discrimination, abuse and neglect. The article makes ten essential recommendations for urgent change across the whole health system and the Inquiry team report contains practical illustrations of how to implement them.
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