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Witek-McManus S, Simwanza J, Msiska R, Mangawah H, Oswald W, Timothy J, Galagan S, Pearman E, Shaikh M, Legge H, Walson J, Juziwelo L, Davey C, Pullan R, Bailey RL, Kalua K, Kuper H. Disability in childhood and the equity of health services: a cross-sectional comparison of mass drug administration strategies for soil-transmitted helminths in southern Malawi. BMJ Open 2024; 14:e083321. [PMID: 39242171 PMCID: PMC11381638 DOI: 10.1136/bmjopen-2023-083321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND School-based approaches are an efficient mechanism for the delivery of basic health services, but may result in the exclusion of children with disabilities if they are less likely to participate in schooling. Community-based 'door to door' approaches may provide a more equitable strategy to ensure that children with disabilities are reached, but disability is rarely assessed rigorously in the evaluation of health interventions. OBJECTIVES To describe the prevalence and factors associated with disability among children aged 5-17 years and to assess the relative effectiveness of routine school-based deworming (SBD) compared with a novel intervention of community-based deworming (CBD) in treating children with disabilities for soil-transmitted helminths. SETTING DeWorm3 Malawi Site (DMS), Mangochi district, Malawi. PARTICIPANTS All 44 574 children aged 5-17 years residing within the DMS. PRIMARY AND SECONDARY OUTCOME MEASURES Disability was defined as a functional limitation in one or more domains of the Washington Group/UNICEF Child Functioning Module administered as part of a community-based census. Treatment of all children during SBD and CBD was independently observed and recorded. For both intervention types, we performed bivariate analyses (z-score) of the absolute proportion of children with and without disabilities treated (absolute differences (ADs) in receipt of treatment), and logistic regression to examine whether disability status was associated with the likelihood of treatment (relative differences in receipt of treatment). RESULTS The overall prevalence of disability was 3.3% (n=1467), and the most common domains of disability were hearing, remembering and communication. Boys were consistently more likely to have a disability compared with girls at all age groups, and disability was strongly associated with lower school attendance and worse levels of education. There was no significant difference in the proportion of children with disabilities treated during SBD when assessed by direct observation (-1% AD, p=0.41) or likelihood of treatment (adjusted risk ratio (aRR)=1.07, 95% CI 0.89 to 1.28). Treatment of all children during CBD was substantially higher than SBD, but again showed no significant difference in the proportions treated (-0.5% AD, p=0.59) or likelihood of treatment (aRR=1.04, 95% CI 0.99 to 1.10). CONCLUSION SBD does not appear to exclude children with disabilities, but the effect of consistently lower levels of educational participation of children with disabilities should be actively considered in the design and monitoring of school health interventions. TRIAL REGISTRATION NUMBER NCT03014167.
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Affiliation(s)
- Stefan Witek-McManus
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - James Simwanza
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Rejoice Msiska
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | | | - William Oswald
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph Timothy
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Sean Galagan
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Emily Pearman
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Mariyam Shaikh
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Hugo Legge
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Judd Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Lazarus Juziwelo
- National Schistosomiasis and STH Control Programme, Community Health Sciences Unit, Ministry of Health & Population, Lilongwe, Malawi
| | - Calum Davey
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachel Pullan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Robin L Bailey
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Hannah Kuper
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Deierlein AL, Park C, Patel N, Gagnier R, Thorpe M. Mental health outcomes across the reproductive life course among women with disabilities: a systematic review. Arch Womens Ment Health 2024:10.1007/s00737-024-01506-5. [PMID: 39222078 DOI: 10.1007/s00737-024-01506-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE This systematic review examined literature on mental health outcomes among women with disabilities living in high-income countries within the context of reproductive health, spanning menstruation through menopause. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, CINAHL, and PsycINFO databases for studies published through June 2023. Eligible studies were observational, quantitative, and included a comparison group without disabilities. RESULTS A total of 2,520 studies were evaluated and 27 studies met inclusion criteria. These studies assessed mental health during prepregnancy, pregnancy, postpartum, and parenting among women with and without disabilities. None of the studies examined reproductive health time periods related to menstruation, fertility, or menopause. Women of reproductive age with disabilities were more likely to have poor mental health outcomes compared to women without disabilities. During pregnancy and the postpartum, women with disabilities were at greater risk of diagnosed perinatal mental disorders and psychiatric-related healthcare visits. Findings also suggested mental distress and inadequate emotional and social support related to parenting among women with disabilities. The greatest risks of poor mental health outcomes were often observed among women with intellectual and developmental disabilities and among women with multiple types of disabilities, compared to women without disabilities. CONCLUSIONS Routine reproductive healthcare visits provide significant prevention and treatment opportunities for poor mental health among women with disabilities. Further research examining mental health outcomes within the context of reproductive health, especially understudied areas of menstruation, fertility, parenting, and menopause, among women with disabilities is needed.
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Affiliation(s)
| | - Curie Park
- School of Global Public Health, New York University, New York, NY, USA
| | - Nishtha Patel
- School of Global Public Health, New York University, New York, NY, USA
| | - Robin Gagnier
- School of Global Public Health, New York University, New York, NY, USA
| | - Michele Thorpe
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Bychkovska O, Tederko P, Strøm V, Juocevicius A, Gemperli A. Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries. J Spinal Cord Med 2024; 47:701-711. [PMID: 36972217 PMCID: PMC11378665 DOI: 10.1080/10790268.2023.2188390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVE To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI). DESIGN Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos et al., 2003) and access to health services was established using univariable and multivariable logistic regression analysis, adjusted for socio-demographic and health status characteristics. SETTING Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland. PARTICIPANTS 6658 adults with chronic SCI. INTERVENTION None. OUTCOME MEASURES Share of persons with SCI that reported unmet healthcare needs as a measure of access. RESULTS Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs. CONCLUSIONS In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | | | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland
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Bolarinwa OA, Odimegwu C, Tapera T. Improving the sexual health of women with disabilities in sub-Saharan Africa: a scoping review of published studies. Reprod Health 2024; 21:116. [PMID: 39107772 PMCID: PMC11304614 DOI: 10.1186/s12978-024-01859-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 08/03/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND An essential aspect of human well-being is positive sexual health outcomes. However, the issue of adverse sexual health outcomes continues to be a major public health concern, particularly for women with disabilities in sub-Saharan Africa (SSA). Therefore, this current scoping review mapped studies conducted in the last twenty-nine years on the sexual health of women with disabilities from these five dimensions: sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour, whilst seeking to identify the current state of knowledge and address the study gaps in SSA. METHODS This current scoping review was informed by the methodological framework proposed by Arksey and O'Malley. Exploratory searches were conducted in PubMed, Web of Science, African Journals Online, etc., to identify studies conducted in SSA that focus on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA since the inception of the International Conference on Population and Development in 1994 to 30th of March 2024. This process resulted in the inclusion of seventeen (17) studies. RESULTS Of the 1362 identified through various databases, 34 studies were included for the full-text retrieval and screening; only 17 studies met the inclusion criteria. The eligible studies were conducted across six countries in SSA and published between 2008 and 2023. Eight studies used quantitative study type, six utilised qualitative approach, and three employed mixed-methods analysis. Two studies were conducted on sexual activity, ten were conducted on contraceptive use, four were conducted on sexual violence, and one study was conducted on risky sexual behaviour, whilst no study on sexual autonomy met the inclusion criteria. CONCLUSION This review showed that there were few or scarce studies on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA and even where the studies were substantial (contraceptive use), the majority of the studies were conducted in a country. Future studies should consider examining dimensions of sexual health, such as sexual autonomy, sexual activity and risky sexual behaviour of women with disabilities that were not available or were scarce in the literature.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Public Health, York St John University, London, UK.
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Talent Tapera
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Holti R, Callahan E, Fletcher J, Hope S, Moller N, Vincent B, Walley P. Improving the integration of care for trans adults: ICTA a mixed-methods study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-217. [PMID: 39259688 DOI: 10.3310/ewta4502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Background This research concerns improving the National Health Service health services trans adults need. These include the national specialist Gender Identity Clinics that support people making a medical transition. Not all trans people need to make a medical transition, and transition can take many different paths. Waits to be seen by Gender Identity Clinics are, however, several years long, and there may be significant problems of co-ordination between different aspects of transition-related care, and between transition-related care and general health care. Objectives The main objectives were to understand: Which factors make services more or less accessible and acceptable to the variety of trans adults? How initiatives for providing more person-centred and integrated care can be successfully implemented and further improved? Design, data sources and participants An online and paper screening survey was used to gather data on demographics and service use of trans people across the United Kingdom, with 2056 responses. Researchers used survey data to construct five purposive subsamples for individual qualitative interviews, identifying groups of people more likely to experience social exclusion or stigma. There were 65 online interviews. In addition, 23 trans Black people and people of colour attended focus groups. Six case studies were completed: four on initiatives to improve care and two on experiences of particular trans populations. Fifty-five service provider staff and 45 service users were interviewed. Results The following undermine person-centred co-ordinated care and can lead to experiences of harm: lack of respectful treatment of trans people by general practitioner practices; inadequate funding of services; lack of support during waiting; the extended and challenging nature of Gender Identity Clinic diagnostic assessments, sometimes experienced as adversarial; breakdowns in collaboration between Gender Identity Clinics and general practitioner practices over hormone therapy; lack of National Health Service psychological support for trans people. Case studies indicated ways to improve care, although each has significant unresolved issues: training in trans health care for general practitioners; third-sector peer-support workers for trans people who come to National Health Services; gender services taking a collaborative approach to assessing what people need, clarifying treatment options, benefits and risks; regional general practitioner-led hormone therapy clinics, bringing trans health care into the mainstream; psychology services that support trans people rather than assess them. Limitations Some contexts of care and experiences of particular groups of trans people were not addressed sufficiently within the scope of the project. While efforts were made to recruit people subject to multiple forms of stigma, there remained gaps in representation. Conclusions and future work The findings have significant implications for commissioners and providers of existing National Health Services gender services, including recently established pilot services in primary care. In particular they point to the need for assessments for access to transition care to be more collaborative and culturally aware, implying the value of exploring informed consent models for accessing transition-related care. Further research is needed to investigate how far the findings apply with particular subpopulations. Study registration This study is registered as Research Registry, no. 5235. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/51/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 28. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Richard Holti
- The Open University Business School, Faculty of Business and Law, Open University, Milton Keynes, UK
| | - Evelyn Callahan
- Department of Health and Social Care, Faculty of Wellbeing, Education and Languages, Open University, Milton Keynes, UK
| | | | | | - Naomi Moller
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Open University, Milton Keynes, UK
| | - Ben Vincent
- The Open University Business School, Faculty of Business and Law, Open University, Milton Keynes, UK
| | - Paul Walley
- The Open University Business School, Faculty of Business and Law, Open University, Milton Keynes, UK
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Namatovu F, Ineland J. Collaboration in providing intimate-partner violence services to women with disabilities. BMC Public Health 2024; 24:1863. [PMID: 38992636 PMCID: PMC11241963 DOI: 10.1186/s12889-024-19352-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND There is a consensus among scholars, policymakers, and implementers that addressing the complex nature of intimate partner violence (IPV) requires a collaborative response. However, there is limited literature on how various professionals work collaboratively to address the needs of women with disabilities who experience IPV. This study combines the perspectives of women with disabilities and those of professionals to understand collaboration in providing IPV services to women with disabilities. METHODS Twenty-nine in-depth interviews were conducted with 18 IPV service providers and 11 women with disabilities. The data were analyzed using reflective thematic analysis. RESULTS The findings are presented under three themes: the first shows a consensus among different IPV service providers and disabled women on the importance of collaboration when supporting victims of IPV with disabilities; the second depicts the common ways in which collaboration occurs when supporting women with disabilities; and the third illuminates the critical elements that boost effective collaboration. CONCLUSION Supporting IPV victims with disabilities requires active collaboration at both an internal and external level. Strengthening collaboration among different actors requires trust, specified roles, and the allocation of adequate resources.
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Affiliation(s)
- Fredinah Namatovu
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-901 87, Sweden.
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, SE-901 87, Sweden.
| | - Jens Ineland
- Department Social Work, Umeå University, Umeå, SE-901 87, Sweden
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Pandya SP. Women with disabilities, body image, and wellbeing: Assessing the effectiveness of dance sessions. J Bodyw Mov Ther 2024; 39:142-155. [PMID: 38876619 DOI: 10.1016/j.jbmt.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 12/04/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION There is growing research evidence on bodily discourses and body image issues of women with disabilities. Within the art-based intervention repertoire for persons with disabilities, dance and movement-based therapies and interventions are gaining prominence. The aim of this study was to examine the impact of dance sessions (delivered online) on body image, body satisfaction/dissatisfaction, and wellbeing of women with disabilities. METHOD A quasi-experimental waitlist control design study was conducted with data collected at two time points: baseline or pre-test and five-months later or post-test. Outcomes were measured using the Body Image Scale and the WHO-5-Wellbeing Index. RESULTS The dance sessions were effective (Hedges' g = -0.56 -0.88; p < 0.01) and post-test body dissatisfaction scores were lower and wellbeing scores were higher for participants with a college degree or postgraduate degree, self-employed or students, and whose intervention compliance was above threshold (>50% dance sessions attended and corresponding homework sessions completed). Tobit regression models indicated that it was possible to estimate post-test outcomes due to dance sessions alone, controlling for significant socio-demographics. DISCUSSION The domain knowledge of non-pharmacological art-based interventions for persons with disabilities, particularly women, is supported. CONCLUSIONS Findings commend dance sessions as effective psychotherapeutic mechanisms to mitigate body dissatisfaction, improve body image and wellbeing of women with disabilities. Future research may focus on large-scale cross-sectional trials, variations in the repertoire for women with different disability types and histories, and qualitative narratives.
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Affiliation(s)
- Samta P Pandya
- Tata Institute of Social Sciences, Sion-Trombay Road, Deonar, Mumbai, 400088, Maharashtra, India.
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Inchai P, Tsai WC, Chiu LT, Kung PT. Cancer stages and mortality risk of breast cancer between women with and without disabilities: A national population-based cohort study in Taiwan. Disabil Health J 2024; 17:101632. [PMID: 38658214 DOI: 10.1016/j.dhjo.2024.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/07/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The second-most common cause of cancer-related death for women worldwide is breast cancer. However, there is little information about breast cancer among women with disabilities in Taiwan. OBJECTIVES This study investigated differences between women with and without disabilities regarding breast cancer stages and evaluated the probability of developing an advanced stage and the mortality risk of breast cancer. METHODS This study conducted a nationwide retrospective cohort study using the National Health Insurance Research Database and other nationwide databases. Our participants were newly diagnosed breast cancer patients, including women with and without disabilities, between 2004 and 2010. We matched both of them with propensity score matching methods (1:5), and all were followed up until the end of 2016. RESULTS This study included 50,683 participants with breast cancer. After matching, women with disabilities who did not receive breast cancer screening had a more significant proportion of advanced-stage breast cancer (19.95 %) than those without disabilities who did not receive breast cancer screening (16.87 %). After adjusting for related variables, women with disabilities were 1.27 times more likely to have advanced-stage breast cancer than those without disabilities. Additionally, after suffering from breast cancer, individuals with disabilities had a 1.23 times greater mortality risk compared to those without disabilities. CONCLUSIONS Although cancer stages were controlled, women with disabilities still had a higher mortality risk of breast cancer. Hence, policymakers should pay more attention to women with disabilities to treat them at an early stage, which can reduce the mortality risk attributable to advanced stages.
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Affiliation(s)
- Puchong Inchai
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Wen-Chen Tsai
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Li-Ting Chiu
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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Margueritte F, Fritel X, Serfaty A, Coeuret-Pellicer M, Fauconnier A. Screening women in young adulthood for disabling dysmenorrhoea: a nationwide cross-sectional study from the CONSTANCES cohort. Reprod Biomed Online 2024; 49:103861. [PMID: 38735232 DOI: 10.1016/j.rbmo.2024.103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/13/2024] [Accepted: 01/30/2024] [Indexed: 05/14/2024]
Abstract
RESEARCH QUESTION How do different warning indicators help to identify disabling dysmenorrhoea among women in young adulthood? DESIGN A nationwide cross-sectional study of women aged 18-25 years from the CONSTANCES cohort was constructed. Disability was assessed with the Global Activity Limitation Indicator question 'For the past 6 months, have you been limited in routine activities?Yes, severely limited/Yes, limited/ No, not limited'. Dysmenorrhoea pain intensity and other chronic pelvic pain symptoms (dyspareunia and non-menstrual pain) were evaluated according to questions from a specific questionnaire. Probability of disability was estimated using a logistic prediction model according to dysmenorrhoea intensity, other indicators of pelvic pain symptoms and other obvious covariates. The results of the predictive model of disabling dysmenorrhoea were presented on a nomogram. RESULTS Among 6377 women, the rate of disability was estimated at 7.5%. Increased intensity of dysmenorrhoea (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.13), increased frequency of dyspareunia (from OR 1.69, 95% CI 1.33-2.14 up to OR 3.41, 95% CI 2.16-5.38) non-menstrual chronic pelvic pain (OR 1.75, 95% CI 1.40-2.19), body mass index over 25 kg/m2 (OR 1.45, 95% CI 1.17-1.80) and non-use of the hormonal contraceptive pill (OR 1.29, 95% CI 1.05-1.59) were significantly associated with disability. According to the nomogram, a predicted probability of 15% or more could be chosen as a threshold. This represents almost 4.6% of young women in this sample being classified at risk of disabling dysmenorrhoea. CONCLUSIONS Dysmenorrhoea pain intensity and associated pelvic pain symptoms are warning indicators that can be measured to help screen young women who may suffer from disabling dysmenorrhoea.
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Affiliation(s)
- François Margueritte
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Primary Care and Prevention Team, CESP, INSERM, Villejuif, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
| | - Xavier Fritel
- Department of Obstetrics and Gynaecology, La Miletrie University Hospital, Poitiers, France; INSERM CIC 1402, Poitiers University, Poitiers, France
| | - Annie Serfaty
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Department of Medical Information, Territorial Hospital Group (GHT), Aisne-Nord/Haute-Somme, Saint Quentin Hospital, Aisne, France
| | - Mireille Coeuret-Pellicer
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Arnaud Fauconnier
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France
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Asim M, Hameed W, Sohail MM, Saleem S, Hayward M, Turan JM. Barriers and facilitators to perinatal care of women with disabilities in lower- and middle-income countries: a study protocol for scoping review of qualitative studies. BMJ Open 2024; 14:e079605. [PMID: 38926146 PMCID: PMC11216051 DOI: 10.1136/bmjopen-2023-079605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 06/02/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The Sustainable Development Goals have put emphasis on equitable healthcare access for marginalised groups and communities. The number of women with disabilities (WWD) to marry and have children is rapidly increasing in low- and middle-income countries (LMICs). However, these women experience multifaceted challenges to seeking perinatal care in LMICs. The objective of this scoping review is to document key facilitators and barriers to seeking perinatal care by WWD. We also will propose strategies for inclusive perinatal healthcare services for women with disabilities in LMICs. METHODS We will conduct a scoping review of peer-reviewed and grey literature (published reports) of qualitative and mixed-methods studies on facilitators and barriers to seeking perinatal care for women with functional disabilities from 2010 to 2023 in LMICs. An electronic search will be conducted on Medline/PubMed, Scopus and Google Scholar databases. Two researchers will independently assess whether studies meet the eligibility criteria for inclusion based on the title, abstract and a full-text review. ETHICS AND DISSEMINATION This scoping review is based on published literature and does not require ethics approval. Findings will be published in peer-reviewed journals and presented at conferences related to reproductive health, disability and inclusive health forums.
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Affiliation(s)
- Muhammad Asim
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Waqas Hameed
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Malik Muhammad Sohail
- Center for Religion, Science and Social Wellbeing, Department of Sociology, University of Chakwal, Chakwal, Punjab, Pakistan
| | - Sarah Saleem
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Mark Hayward
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
- Department of Sociology, The University of Texas at Austin, Austin, Texas, USA
| | - Janet M Turan
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Hai Anh NT, Vinh NT. Access to online business opportunities: Enhancing digital technology capacity for women with disabilities in the Red River Delta of Vietnam. Heliyon 2024; 10:e32473. [PMID: 38933956 PMCID: PMC11201116 DOI: 10.1016/j.heliyon.2024.e32473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
This study investigates the digital technology capacity of women with disabilities and the impact of access to digital business opportunities on their entrepreneurial satisfaction. A sample of 50 women with disabilities in the Red River Delta region of Vietnam provided 35 valid responses, which were analyzed using Exploratory Factor Analysis and Structural Equation Modeling. The results showed that five key factors, including course relevance, course expectancy, instructor quality, learning outcomes, and course satisfaction, accounted for 78.39 % of the variance in the data. The proposed model explained 61.3 % of the amount of variation and the study's findings supported the predicted relationships among the factors, except for two hypotheses. H1, which postulated a positive relationship between course relevance and instructor quality, and H5, which predicted a positive relationship between learning outcomes and course satisfaction. Possible reasons for these non-significant relationships were discussed, highlighting the need for further research in these areas. The findings contribute to our understanding of the factors that affect the digital technology capacity of women with disabilities and their satisfaction with digital business opportunities.
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Affiliation(s)
- Nguyen Thi Hai Anh
- Faculty of Arts and Communication, Thai Nguyen University of Information and Communication Technology, Thai Nguyen, Viet Nam
| | - Nguyen The Vinh
- Faculty of Information Technology, Thai Nguyen University of Information and Communication Technology, Thai Nguyen, Viet Nam
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12
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Hamzah KQA, Mohd Zulkefli NA, Ahmad N. Health-seeking behaviour during times of illness among urban poor women: a cross-sectional study. BMC Womens Health 2024; 24:334. [PMID: 38849787 PMCID: PMC11157716 DOI: 10.1186/s12905-024-03178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Urban poor women face dual challenges regarding gender inequalities and urban poverty, which make them more likely to have health problems and affect their health-seeking behaviour. This study aimed to determine the prevalence of health-seeking behaviour during times of illness and predictors of sought care among urban poor women in Kuala Lumpur, Malaysia. METHODS This cross-sectional study was performed among 340 randomly selected women residents from April to May 2023. Data was collected using a validated and reliable self-administered questionnaire and analysed using SPSS version 28.0 software. The dependent variable in this study was health-seeking behaviour during times of illness, while the independent variables were sociodemographic characteristics, socioeconomic characteristics, medical conditions, women's autonomy in decision-making, social support, perceived stigma, and attitude towards health. Multiple logistic regression was used to identify the predictors of sought care during times of illness. RESULTS Study response rate was 100%, where 72.4% sought care during times of illness. Being non-Malay (AOR = 4.33, 95% CI: 1.847, 10.161), having healthcare coverage (AOR = 2.60, 95% CI: 1.466, 4.612), rating their health as good (AOR = 1.87, 95% CI: 1.119, 3.118), and having pre-existing chronic diseases (AOR = 1.92, 95% CI: 1.130, 3.271) were identified as predictors of sought care during times of illness. CONCLUSION The present study showed that health-seeking behaviour during times of illness among the participants was appropriate. Health promotion and education, with a focus on educating and raising awareness about the importance of seeking timely healthcare, are crucial to improving health-seeking behaviour among urban poor women. Collaboration with relevant stakeholders is needed to develop comprehensive strategies to improve access to healthcare facilities for these women.
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Affiliation(s)
- Khadijahtul Qubra Amizah Hamzah
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
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13
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Ferguson JM, Goldstein KM, Zullig LL, Zulman DM. Gender Differences in Adoption and Frequency of Virtual Primary Care Among Men and Women Veterans. J Womens Health (Larchmt) 2024; 33:749-757. [PMID: 38629443 DOI: 10.1089/jwh.2023.0781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
Background: Women Veterans have unique health care utilization patterns; however, video-based primary care utilization among and between women and men has not been well examined. Methods: In a retrospective cohort study, we calculated gender-stratified video visit adoption (i.e., likelihood) and frequency (i.e., rate of use among users) between April 1, 2020, and March 31, 2022, by demographic and clinical characteristics known to impact health care utilization. Results: Among 5,389,139 Veterans (9.2% women), 32% of women and 18.6% of men had a video-based primary care visit over the 2-year study period. Gender interacted with Veteran characteristics and the likelihood of any video care. Men often had associations stronger in magnitude (both positive and negative) than women, including by age, rurality, history of housing instability, mental health conditions, and marital status. The direction of effect never diverged by gender. A positive association among women always coincided with a positive association among men, and vice versa, across all characteristics assessed. Only the risk ratio for video care use comparing Veterans of Black race with White race was stronger among women. In contrast to the video care adoption differences by gender, we found few differences in the frequency of video-based care by gender. Conclusions: The findings suggest there are fewer disparities by demographic and clinical characteristics in any video care use among women compared with men and little to no disparities in the frequency of video care use by gender. Understanding the variation in video care utilization by gender could help improve acceptance, appropriate utilization, and uptake of video-based visits for all.
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Affiliation(s)
- Jacqueline M Ferguson
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA
| | - Karen M Goldstein
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA
- Division of General Internal Medicine, Duke University, Durham, North Carolina, USA
| | - Leah L Zullig
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Durham, North Carolina, USA
| | - Donna M Zulman
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
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14
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Bychkovska O, Pattanakuhar S, Arora M, Postma K, Strøm V, Joseph C, Tederko P, Gemperli A. Gender differences in patient experience among persons with spinal cord injury: A comparison across 22 countries. Disabil Health J 2024:101642. [PMID: 38796406 DOI: 10.1016/j.dhjo.2024.101642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 05/02/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Due to the majority of males within the population of persons with spinal cord injuries (SCI), a male-oriented perception of persons with SCI might affect care provision in the way of prioritizing male needs. OBJECTIVE The objective of this cross-sectional study is to describe the patient experience of persons with SCI by gender. METHODS This study was based on the International Spinal Cord Injury Survey with 12,588 participants from 22 countries. An interval-based patient experience score was attained by partial credit model. Regression analysis was used in exploring the association between patient experience and gender. RESULTS Participants reported very good and good patient experience. Respectful treatment was reported by 78 % of participants; clear explanations by 75 %; involvement in decision-making by 71 %; satisfaction with services by 62 %. The average patient experience score was equal among males and females (average: 64, range: 0-100), with the highest score in participants from the USA (78) and the lowest - in Morocco (44). Patient experience score was not associated with gender. Females had lower odds of reporting better decision-making involvement, yet higher odds of better satisfaction. Older participants, with higher household income and better self-rated health, had lower odds of being satisfied. CONCLUSION The majority of persons with SCI rated their experience as good or very good. Females were more likely to report higher satisfaction with services and lower involvement in decision-making. For other patient experience categories and the overall patient experience score, no association with gender was found.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Sintip Pattanakuhar
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Rehabilitation Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia; The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Karin Postma
- Rijndam Rehabilitation Center, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
| | - Conran Joseph
- Division of Physiotherapy, Stellenbosch University, Stellenbosch, South Africa.
| | - Piotr Tederko
- Rehabilitation Clinic, Postgraduate Medical Education Centre, Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Otwock, Poland.
| | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland.
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15
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Lee KW, Yap SF, Murdan S, Zainudin Z, Abdul Hamid H, Emamjomeh M, Mohd Desa MN, Sither Joseph NM, Azmai Amal MN, Amin-Nordin S. Maternal and neonatal group B streptococcus colonisation: A systematic review and the meta-analysis of matched-pair studies. Acta Paediatr 2024; 113:892-911. [PMID: 38351491 DOI: 10.1111/apa.17152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 04/11/2024]
Abstract
AIM To determine the prevalence of group B Streptococcus (GBS) carriage among parturient women and neonates, and the relative risk of vertical transmission, the relative risk of early and late-onset GBS and the pooled incidence of early-late-onset GBS infection. METHODS A systematic search of relevant cohort studies from three electronic databases to identify all relevant studies published up to 7 November 2022. The review was conducted in accordance with PRISMA guidelines. Estimates were pooled using random-effects meta-analyses. RESULTS A total of 54 articles with 355 787 matched pairs of parturient women and neonates from 30 countries were included in the analysis. The pooled prevalence of GBS colonisation was 17.1% among the pregnant women and 1.0% among neonates. The pooled prevalence of vertical transmission of GBS was 4.5% and the pooled relative risk of GBS colonisation of neonates born to mothers with GBS was 9.9. CONCLUSION We support the implementation of targeted intrapartum antibiotic prophylaxis for all women who are positive for GBS as well as women with risks factors for early onset GBS in their infants regardless of their GBS colonisation status.
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Affiliation(s)
- Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sook Fan Yap
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
- Centre for Research on Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | - Sudaxshina Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, London, UK
| | - Zurina Zainudin
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Habibah Abdul Hamid
- Department of Obstetric and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohsen Emamjomeh
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Nasir Mohd Desa
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Narcisse Mary Sither Joseph
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohammad Noor Azmai Amal
- Department of Biology, Faculty of Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Syafinaz Amin-Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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16
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Kuper H, Azizatunnisa' L, Gatta DR, Rotenberg S, Banks LM, Smythe T, Heydt P. Building disability-inclusive health systems. Lancet Public Health 2024; 9:e316-e325. [PMID: 38702096 DOI: 10.1016/s2468-2667(24)00042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/20/2023] [Accepted: 02/21/2024] [Indexed: 05/06/2024]
Abstract
Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities. This Review provides an overview of the existing evidence on health inequities faced by people with disabilities and describes existing approaches to making health systems disability inclusive. Our Review documents a broad range of health-care inequities for people with disabilities (eg, lower levels of cancer screening), which probably contribute towards health differentials. We identified 90 good practice examples that illustrate current strategies to reduce inequalities. Implementing such strategies could help to ensure that health systems can expect, accept, and connect people with disabilities worldwide, deliver on their right to health, and achieve health for all.
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Affiliation(s)
- Hannah Kuper
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Missing Billion Initiative, Seattle, WA, USA.
| | - Luthfi Azizatunnisa'
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Danae Rodríguez Gatta
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Missing Billion Initiative, Seattle, WA, USA
| | - Sara Rotenberg
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lena Morgon Banks
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Tracey Smythe
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
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17
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Zirnsak T, Elwyn R, McLoughlan G, Le Couteur E, Green C, Hill N, Roberts R, Maylea C. "I have to fight for them to investigate things": a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness. Front Public Health 2024; 12:1360561. [PMID: 38751585 PMCID: PMC11095107 DOI: 10.3389/fpubh.2024.1360561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Women play a significant role in the management of their own healthcare and that of others, however women diagnosed with mental illness and physical health concerns experience significant health inequalities as compared to people living without mental health concerns. Methods In this paper, we reflect on the experiences of 20 cis women diagnosed with mental and physical health concerns who agreed to be a part of this research. This qualitative study is part of the larger Healthtalk Australia research project which was not gender specific. Female participants shared many experiences of mental and physical healthcare in interviews with researchers that pointed to the need for a gendered approach to addressing health inequalities. Consequently, we iteratively consolidated transcripts of interviews with participants into thematic categories facilitated by NVIVO 12. Results We identified two broad themes and a set of subthemes: in the doctor's office - experience of labelling; negotiating medications; and interactions with physical and mental health, and outside the doctor's office - responses to trauma, financial concerns, and reliance on participant's internal resources to get healthcare needs met. Discussion We conclude that participants in this study undertook significant work to manage their own healthcare needs, despite being challenged by clinicians and systems that failed to see them as whole people with expertise regarding their own health.
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Affiliation(s)
- Tessa Zirnsak
- Social Work and Social Policy, Department Clinical and Community Health, La Trobe University, Bundoora, VIC, Australia
| | - Rosiel Elwyn
- Neuroscience and Psychiatry, Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | | | - Esther Le Couteur
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Chloe Green
- Department of English, Drama and Film, University College Dublin, Dublin, Ireland
| | - Nicholas Hill
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
- School of Social and Political Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Russell Roberts
- School of Business, Charles Sturt University, Bathurst, NSW, Australia
| | - Chris Maylea
- School of Law, La Trobe University, Melbourne, VIC, Australia
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18
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Rodríguez Gatta D, Rotenberg S, Allel K, Reichenberger V, Banks LM, Kuper H. Access to general health care among people with disabilities in Latin America and the Caribbean: a systematic review of quantitative research. LANCET REGIONAL HEALTH. AMERICAS 2024; 32:100701. [PMID: 38495313 PMCID: PMC10943476 DOI: 10.1016/j.lana.2024.100701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 03/19/2024]
Abstract
In Latin America and the Caribbean (LAC), there are 85 million people with disabilities (PwD). They often experience barriers accessing healthcare and die, on average, 10-20 years earlier than those without disabilities. This study aimed to systematically review the quantitative literature on access to general healthcare among PwD, compared to those without disabilities, in LAC. A systematic review and narrative synthesis was conducted. We searched in EMBASE, MEDLINE, LILACS, MedCarib, PsycINFO, SciELO, CINAHL, and Web of Science. Eligible articles were peer-reviewed, published between January 2000 and April 2023, and compared healthcare access (utilization, coverage, quality, affordability) between PwD and without disabilities in LAC. The search retrieved 16,538 records and 30 studies were included, most of which had a medium or high risk of bias (n = 23; 76%). Overall, the studies indicated that PwD use healthcare services more than those without disabilities. Some evidence indicated that women with disabilities were less likely to have received cancer screening. Limited evidence showed that health services affordability and quality were lower among PwD. In LAC, PwD appear to experience health inequities, although large gaps exist in the current evidence. Harmonization of disability and health access data collection is urgently needed to address this issue.
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Affiliation(s)
- Danae Rodríguez Gatta
- International Centre of Evidence and in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Millennium Nucleus Studies on Disability and Citizenship (DISCA), Chile
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Kasim Allel
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Government, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Veronika Reichenberger
- International Centre of Evidence and in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lena Morgon Banks
- International Centre of Evidence and in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hannah Kuper
- International Centre of Evidence and in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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19
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Hickey EJ, Caudill A, Laufenberg H, Hrabik L, DaWalt L, Ausderau KK. Quality of life, satisfaction with care, and the experiences of adults with intellectual and developmental disabilities before and during COVID-19. Disabil Health J 2024; 17:101545. [PMID: 37980230 PMCID: PMC10999343 DOI: 10.1016/j.dhjo.2023.101545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/27/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDD) experienced significant disruptions in their access to health care, support services, and essential daily activities such as work, leisure, and routine daily care during COVID-19. OBJECTIVE The purpose of this study was to describe overall experiences related to COVID-19 among adults with IDD, including the vaccination process, quality of life (QoL), and service satisfaction before and during the pandemic. METHODS A longitudinal statewide survey of adults with IDD receiving long-term care support using a combination of self- and care partner report was completed prior to (2017; n = 331) and during (2021; n = 206) the pandemic. RESULTS Qualitative results identified specific vaccine barriers, vaccine decision influencers, and general experiences during COVID-19 for adults with IDD. The importance of support staff, vaccine availability, disruption in daily activities, social context, and mental health implications were noted in responses to all three topics. Quantitative results showed lower QoL during COVID-19 (M = 2.99 vs. 3.14, p = .028); however, when reporter (self vs. care partner) and age were added to the model, differences between pre-vs. during-COVID were no longer significant. No significant differences in satisfaction of services were noted pre-vs. during-COVID-19. Ninety-six percent of respondents reported access to the vaccine, and 16 % experienced barriers getting the vaccine. QoL was associated with receiving the COVID-19 vaccine (r = 0.15, p = .036), level of agreement that the vaccine is safe (r = 0.17, p = .024), and level of agreement that getting the vaccine will help protect other vulnerable people in the community (r = .25, p = .001). Level of satisfaction with quality of services was also associated with level of agreement that the vaccine is safe (r = 0.15, p = .048). CONCLUSIONS Overall, a better understanding of service continuation, support practices, and experiences related to COVID-19 will prepare us for future environmental and health crises by identifying areas for improvement, intervention, and policy change to meet the ongoing needs of adults with IDD.
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Affiliation(s)
- Emily J Hickey
- Waisman Center, University of Wisconsin-Madison, University of Wisconsin-Madison, Madison, WI, USA.
| | - Allison Caudill
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Hannah Laufenberg
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Lynn Hrabik
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Leann DaWalt
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
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20
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Shams L, Nasiri T, Darvish T, Hosseini-Shokouh SM, Amiri MM. Barriers to financial access of disabled people to health services in rural areas: A case study of Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:89. [PMID: 38720686 PMCID: PMC11078468 DOI: 10.4103/jehp.jehp_63_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND People with disabilities (PWDs) account for a significant percentage of the world's population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD's access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue. MATERIALS AND METHODS Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the P value <0.05. RESULTS The mean score of PWD's access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant (P < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect (P < 0.05). CONCLUSION This study demonstrated the seriousness of paying attention to PWD's financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.
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Affiliation(s)
- Lida Shams
- Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taha Nasiri
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Health Services Management, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tahere Darvish
- Department of Community Health Education, Virtual School of Medical and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayyed-Morteza Hosseini-Shokouh
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Health Services Management, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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21
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Linares Terrazas D, Luna Barrón B, Taboada López G. [Inequalities in time to diagnosis of Down Syndrome in Bolivia]. Salud Colect 2024; 20:e4710. [PMID: 38512123 DOI: 10.18294/sc.2024.4710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
Down Syndrome is the most common genetic condition and a leading cause of intellectual disability. Individuals in rural areas, particularly those with disabilities, often face disparities in healthcare access. Analyzing clinical records of patients diagnosed with Down Syndrome between 2013 and 2022 by the Institute of Genetics at the Universidad Mayor de San Andrés in La Paz, Bolivia, this study examined the time to diagnosis for 250 patients with Down Syndrome. The findings revealed that patients from rural areas with Down Syndrome take an average of five months to receive a diagnosis, compared to two months in urban areas (p<0.001). No significant differences were found in the time to diagnosis based on gender. However, a higher proportion of males from rural areas was observed (p=0.03). The results suggest that individuals in rural areas face challenges in receiving a timely diagnosis. On the other hand, women may not be brought to cities for proper diagnosis and treatment due to gender biases in certain communities. The importance of improving access to early diagnosis and treatment in rural areas is emphasized.
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Affiliation(s)
- Daniel Linares Terrazas
- Médico. Auxiliar de investigación, Unidad de Citogenética, Instituto de Genética, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Beatriz Luna Barrón
- Médica. Docente investigadora, Instituto de Genética, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Gonzalo Taboada López
- Médico. Docente investigador, Instituto de Genética, Universidad Mayor de San Andrés, La Paz, Bolivia
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22
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Reichenberger V, Corona AP, Ramos VD, Shakespeare T, Hameed S, Penn-Kekana L, Kuper H. Access to primary healthcare services for adults with disabilities in Latin America and the Caribbean: a review and meta-synthesis of qualitative studies. Disabil Rehabil 2024:1-10. [PMID: 38433528 DOI: 10.1080/09638288.2024.2320268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE This review and meta-synthesis of qualitative studies aims to provide an overview of qualitative evidence on primary healthcare access of people with disability in Latin America and the Caribbean, as well as to identify barriers that exist in this region. METHODS Six databases were searched for studies from 2000 to 2022. 34 qualitative studies were identified. RESULTS Barriers exist on both demand and supply sides. The thematic synthesis process generated three broad overarching analytical themes, which authors have related to Levesque et al.'s aspects of "ability to perceive," "availability, accommodation and ability to reach" and "appropriateness and ability to engage." Access to information and health literacy are compromised due to a lack of tailored health education materials. Barriers in the urban environment, including inadequate transportation, and insufficient healthcare facility accessibility create challenges for people with disabilities to reach healthcare facilities independently. Attitudinal barriers contribute to suboptimal care experiences. CONCLUSION People with disabilities face several barriers in accessing healthcare. Lack of healthcare provider training, inappropriate urban infrastructure, lack of accessible transport and inaccessibility in healthcare centers are barriers that need to be addressed. With these actions, people with disabilities will be closer to having their rights met.
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Affiliation(s)
- Veronika Reichenberger
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Paula Corona
- Department of Hearing and Speech Sciences, Multidisciplinary Institute of Rehabilitation and Health, Federal University of Bahia, Salvador, Brazil
| | - Vinicius Delgado Ramos
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Shaffa Hameed
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Loveday Penn-Kekana
- Epidemiology and Public Health, Maternal and Neonatal Health Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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23
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Shields N, Bhowon Y, Prendergast L, Cleary S, Taylor NF. Fostering positive attitudes towards interacting with young people with disability among health students: a stepped-wedge trial. Disabil Rehabil 2024; 46:1212-1219. [PMID: 37101339 DOI: 10.1080/09638288.2023.2193429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/16/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE To investigate if a 12-week community-based exercise program (FitSkills) fostered positive attitudes towards disability among university student mentors. METHODS A stepped-wedge cluster randomised trial was completed with 4 clusters. Students were eligible to be a mentor if enrolled in an entry-level health degree (any discipline, any year) at one of three universities. Each mentor was matched with a young person with a disability and the pair exercised together at the gym twice a week for an hour (24 sessions total). At 7 times over 18 months, mentors completed the Disability Discomfort Scale to indicate their level of discomfort when interacting with people with disability. Data were analysed according to the intention to treat principles using linear mixed-effects models to estimate changes in scores over time. RESULTS A total of 207 mentors completed the Disability Discomfort Scale at least once, of whom 123 participated in FitSkills. Analysis found an estimated reduction of 32.8% (95% confidence interval (CI) -36.8 to -28.4) in discomfort scores immediately after exposure to FitSkills across all four clusters. These decreases were sustained throughout the remainder of the trial. CONCLUSIONS Mentors reported more positive attitudes towards interacting with people with disability after completing FitSkills with changes retained for up to 15 months.
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Affiliation(s)
- Nora Shields
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Yeshna Bhowon
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Luke Prendergast
- Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Stacey Cleary
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia
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24
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Post SM, Jobe MC, Malekzadeh AN, AuBuchon KE, Hoffman RK, Stock ML, Bowleg L. Watching the fall of Roe v. Wade: Media exposure relates to U.S. women's alcohol use intentions. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:197-204. [PMID: 37676169 PMCID: PMC10918026 DOI: 10.1037/adb0000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
OBJECTIVE The Supreme Court of the United States' decision in Dobbs v. Jackson Women's Health Organization in June 2022 overturned Roe v. Wade and ended federal protection of abortion rights. Given the drastic policy changes as a result of the ruling and high exposure to media related to abortion, women opposed to the decision may have experienced distress, which could trigger maladaptive coping strategies, such as alcohol use. The present research examined how consuming abortion-related media in the weeks following the Dobbs decision impacted alcohol use intentions among women of reproductive age residing in the 13 "trigger law" states that immediately restricted abortion access. METHOD A sample of 196 women (Mage = 30.52, SD = 6.9) residing in trigger law states answered questions about abortion-related media consumption, views toward the Dobbs ruling, negative affect, and alcohol use intentions. RESULTS Consuming more abortion-related media predicted higher alcohol use intentions for women who opposed the ruling, but not those who were in favor of abortion restrictions. CONCLUSIONS This timely study provides evidence of how the Dobbs ruling is associated with health ramifications beyond reproduction, yielding insights about how high media exposure to large-scale, distressing events may put those most affected-women of reproductive age in states that enacted new policies restricting abortion access-at risk for alcohol use. Findings highlight an imperative direction for future research as abortion restrictions continue to be spotlighted in U.S. media and state legislatures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Stacy M Post
- Department of Psychological and Brain Sciences, George Washington University
| | - Mary C Jobe
- Department of Psychological and Brain Sciences, George Washington University
| | | | - Katarina E AuBuchon
- Department of Psychological and Brain Sciences, George Washington University
| | - Rebecca K Hoffman
- Department of Psychological and Brain Sciences, George Washington University
| | - Michelle L Stock
- Department of Psychological and Brain Sciences, George Washington University
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, George Washington University
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25
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Sivasubramanian N, Pinalben Madhabhai C, Shilpa Gottlieb A, Mahalakshmi B, Vaghela P, Garg S. Knowledge, attitudes and demographic effect on menopausal experiences among Indian rural women. Bioinformation 2024; 20:175-179. [PMID: 38497080 PMCID: PMC10941773 DOI: 10.6026/973206300200175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
The menopausal experiences of women in selected rural areas of Visnagar, addressing a research gap within cultural and socio-economic landscapes is of interest. The global aging trend was reflected in the 26% representation of women aged 50 and over in the study. Employing a cross-sectional design, 200 menopausal women were sampled through stratified random sampling, emphasizing demographic diversity. Results from a structured Knowledge Questionnaire and a Likert Scale for Attitude revealed that women generally possessed commendable knowledge (mean score 10.94) and positive attitudes (mean score 28.66) toward menopause. Significant associations between age, education, occupation, and income with knowledge and attitudes were uncovered through chi-square tests. This study underscored the need for tailored interventions in rural settings, considering the influence of cultural, regional, and demographic factors on menopausal experiences. The findings contributed to bridging the research gap and emphasized the importance of individualized approaches for promoting the well-being of menopausal women in rural communities.
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Affiliation(s)
- N Sivasubramanian
- Department of Psychiatric Nursing, Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat - 384315, India
| | - Chaudhari Pinalben Madhabhai
- Department of Pediatric Nursing, Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat - 384315, India
| | - Amita Shilpa Gottlieb
- Department of obstetric and gynaecological Nursing, Graphic Era College of Nursing, Graphic Era Deemed to be University, Dehradun, Uttarakhand -248002, India
| | - B Mahalakshmi
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat - 384315, India
| | - Payal Vaghela
- Department of Community health Nursing, College of Nursing, S.G.R.R University, Dehradun, Uttarkhand - 248001, India
| | - Sandeep Garg
- Mewar Bsc Nursing College, Udaipur, Rajasthan - 313001, India
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26
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Kokorelias KM, Lee TSJ, Bayley M, Seto E, Toulany A, Nelson MLA, Dimitropoulos G, Penner M, Simpson R, Munce SEP. A Web-Based Peer-Patient Navigation Program (Compassionate Online Navigation to Enhance Care Transitions) for Youth Living With Childhood-Acquired Disabilities Transitioning From Pediatric to Adult Care: Qualitative Descriptive Study. JMIR Pediatr Parent 2024; 7:e47545. [PMID: 38324351 PMCID: PMC10882481 DOI: 10.2196/47545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Studies have highlighted significant challenges associated with the transition from pediatric to adult health and social care services for youth living with childhood-acquired disabilities and their caregivers. Patient navigation has been proposed as an effective transitional care intervention. Better understanding of how patient navigation may support youth and their families during pediatric to adult care transitions is warranted. OBJECTIVE This study aims to describe the preferred adaptations of an existing web-based platform from the perspectives of youth with childhood-onset disabilities and their family caregivers to develop a web-based peer-patient navigation program, Compassionate Online Navigation to Enhance Care Transitions (CONNECT). METHODS A qualitative descriptive design was used. Participants included youth living with childhood-acquired disabilities (16/23, 70%) and their caregivers (7/23, 30%). Semistructured interviews and focus groups were conducted, digitally recorded, and transcribed. Thematic analysis was used to analyze the data and was facilitated through NVivo software (Lumivero). RESULTS Participants desired a program that incorporated (1) self-directed learning, (2) a library of reliable health and community resources, and (3) emotional and social supports. On the basis of participants' feedback, CONNECT was deemed satisfactory, as it was believed that the program would help support appropriate transition care through the provision of trusted health-related information. Participants highlighted the need for options to optimize confidentiality in their health and social care and the choice to remain anonymous to other participants. CONCLUSIONS Web-based patient navigation programs such as CONNECT may deliver peer support that can improve the quality and experience of care for youth, and their caregivers, transitioning from pediatric to adult care through personalized support, health care monitoring, and health and social care resources. Future studies are needed to test the feasibility, acceptability, usability, use, and effectiveness of CONNECT among youth with childhood-onset disabilities.
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Affiliation(s)
- Kristina Marie Kokorelias
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Department of Occupational Sciences and Occupational Therapy, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tin-Suet Joan Lee
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Mark Bayley
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Center for Digital Therapeutics, University Health Network, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Alene Toulany
- Department of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michelle L A Nelson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | | | - Melanie Penner
- Department of Pediatrics, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Robert Simpson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences, Toronto, ON, Canada
| | - Sarah E P Munce
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Department of Occupational Sciences and Occupational Therapy, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Anshebo AA, Markos Y, Behera S, Gopalan N. Contraceptive dynamics among women with disabilities of reproductive age in Ethiopia: systematic review. Syst Rev 2024; 13:42. [PMID: 38279168 PMCID: PMC10811808 DOI: 10.1186/s13643-024-02456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND In low-income countries, women with disabilities have limited access to essential sexual and reproductive health services and are disadvantaged socioeconomically. Even though some studies have been conducted previously, there are scanty findings on contraceptive use and associated factors among women with disabilities. Thus, this systematic review aimed to assess contraceptive use and associated factors among women with disabilities of reproductive age in Ethiopia. METHODS The Preferred Reporting Item for Systematic Review and Meta-Analyses [PRISMA] guidance is used to conduct this systematic review. Data were searched from electronic databases: PubMed/Medline, Scopus, Google Scholar, and other relevant sources. Studies screening was done using Rayyan software. The findings were narratively synthesized using a socio-ecological framework for health promotion. RESULT Ten cross-sectional studies and 4436 women with disabilities of reproductive age were included in this review. According to this review, women with disabilities are less likely to use contraceptives, with a prevalence of 21.7% in Gondor City and 44.4% in Addis Ababa. The associated factors were identified and themed at individual, interpersonal, community, and institutional levels. CONCLUSION Overall, the review findings revealed that women with disabilities continue to encounter challenges ranging from individual level to disability-unfriendly health facility infrastructure or institutional level. Therefore, health professionals and other relevant stakeholders should draw attention to creating awareness towards contraceptive use at individual and interpersonal levels, ensuring accessible contraceptive services and disability-friendly health facilities.
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Affiliation(s)
- Abebe Alemu Anshebo
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India.
- Deparment of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
| | - Yilma Markos
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Sujit Behera
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
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Karami B, Rezaei S, Gillan HD, Akbari S, Maleki R, Moradi F, Jalili F, Karami M, Soltani S. Inpatient healthcare utilization among people with disabilities in Iran: determinants and inequality patterns. BMC Health Serv Res 2024; 24:62. [PMID: 38212742 PMCID: PMC10785394 DOI: 10.1186/s12913-023-10383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/26/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND People with disabilities (PWD) have different health service needs and different factors affect the utilization of these services. Therefore, the aim of this present study was to identify determinants of inpatient healthcare utilization among PWDs in Iran. METHODS This research was a secondary data analysis of a cross-sectional study. The present study used data gathered for 766 PWDs (aged 18 years and older) within the Iranian Society with Disabilities (ISD) between September and December 2020. Multiple logistic regression models calculated adjusted odds ratios (aOR) and 95% confidence intervals in order to identify determinants of inpatient healthcare utilization among PWDs. RESULTS Data for 766 people with disabilities were analyzed. A large number of participants were over 28 years of age (70.94%), male (64.36%), and single (54.02%). In the present study, more than 71% of participants had no history of hospitalization during the last year. In this study, males [aOR 2.11(1.14-3.91), participants with Civil Servants health insurance coverage [aOR 3.44 (1.16 - 10.17)] and individuals in the 3th quartile of disability severity [aOR 2.13 (1.01 - 4.51)] had greater odds of inpatient healthcare utilization compared to the other groups. The value of the concentration index (C) for inpatient healthcare utilization was - 0.084 (P.value = 0.046). The decomposition analysis indicated that gender was the greatest contributor (21.92%) to the observed inequality in inpatient healthcare utilization among participants. CONCLUSION Our findings suggested that the likelihood of hospitalization among the study participants could be significantly influenced by factors such as gender, the health insurance scheme, and the degree of disability severity. These results underscore the imperative for enhanced access to outpatient services, affordable insurance coverage, and reduced healthcare expenditures for this vulnerable population. Addressing these issues has the potential to mitigate the burden of hospitalization and promote better health outcomes for disadvantaged individuals.
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Affiliation(s)
- Badriyeh Karami
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Darvishi Gillan
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Akbari
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Raheleh Maleki
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fardin Moradi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Faramarz Jalili
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Mohammad Karami
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Azizatunnisa L, Rotenberg S, Shakespeare T, Singh S, Smythe T. Health-worker education for disability inclusion in health. Lancet 2024; 403:11-13. [PMID: 38048789 DOI: 10.1016/s0140-6736(23)02707-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Luthfi Azizatunnisa
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Sara Rotenberg
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | - Satendra Singh
- University College of Medical Sciences, University of Delhi, Delhi, India
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
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30
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Chowdhury S, Rahman MM, Haque MA. Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review. AJOG GLOBAL REPORTS 2023; 3:100239. [PMID: 37396340 PMCID: PMC10310482 DOI: 10.1016/j.xagr.2023.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Research on fertility and reproductive health has expanded rapidly. However, questions regarding the association between women empowerment and fertility in terms of the reproductive health status in Bangladesh remain unanswered. This study aimed to address these questions through a systematic literature review. METHODS In this review study, the PubMed, Scopus, Banglajol, and Google Scholar databases were searched systematically and screened in terms of the inclusion and exclusion criteria. Data from 15 articles included in this review were extracted for further assessment. RESULTS Fifteen studies with a total of 212,271 participants from Bangladesh met our selection criteria. Most of the articles were conducted on ever-married women aged 15 to 49 years using nationally representative Bangladesh Demographic and Health Survey data. The major religions were Islam (86.8%-90.2%) and Hinduism (10%-13%). The age of women at first marriage varied from 14 to 20 years, and the age at first birth ranged from 16 to 22 years. The fertility rate in Bangladesh has reduced remarkably over the period from 1975 to 2022. After controlling for other social and health factors, the study found that empowerment factors such as women's education, working status, involvement in household decision-making, participation in economic decision-making, and freedom in movement influenced the fertility and reproductive health status in Bangladesh. CONCLUSION As an initial step, this study found a negative relationship between women's empowerment and the control of fertility and reproductive health. Greater policy focus should be directed toward women empowerment factors to improve the fertility situation and reproductive health status in Bangladesh and other countries with similar sociodemographic profiles.
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Affiliation(s)
- Shanjida Chowdhury
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh (Ms Chowdhury and Dr Haque)
- Southeast Business School, Southeast University, Dhaka, Bangladesh (Ms Chowdhury)
| | - Mohammad Meshbahur Rahman
- Department of Biostatistics, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, Bangladesh (Mr Rahman)
| | - Md. Aminul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh (Ms Chowdhury and Dr Haque)
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Ramšak M, Orzechowski M, Bielińska K, Chowaniec A, Doričić R, Nowak M, Skuban-Eiseler T, Tutić Grokša I, Łuków P, Muzur A, Zupanič-Slavec Z, Steger F. Diversity awareness, diversity competency and access to healthcare for minority groups: perspectives of healthcare professionals in Croatia, Germany, Poland, and Slovenia. Front Public Health 2023; 11:1204854. [PMID: 37546324 PMCID: PMC10400770 DOI: 10.3389/fpubh.2023.1204854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Due to cultural, language, or legal barriers, members of social minority groups face challenges in access to healthcare. Equality of healthcare provision can be achieved through raised diversity awareness and diversity competency of healthcare professionals. The aim of this research was to explore the experiences and attitudes of healthcare professionals toward the issue of social diversity and equal access to healthcare in Croatia, Germany, Poland, and Slovenia. Methods The data reported come from semi-structured interviews with n = 39 healthcare professionals. The interviews were analyzed using the methods of content analysis and thematic analysis. Results Respondents in all four countries acknowledged that socioeconomic factors and membership in a minority group have an impact on access to healthcare services, but its scope varies depending on the country. Underfunding of healthcare, language barriers, inadequate cultural training or lack of interpersonal competencies, and lack of institutional support were presented as major challenges in the provision of diversity-responsive healthcare. The majority of interviewees did not perceive direct systemic exclusion of minority groups; however, they reported cases of individual discrimination through the presence of homophobia or racism. Discussion To improve the situation, systemic interventions are needed that encompass all levels of healthcare systems - from policies to addressing existing challenges at the healthcare facility level to improving the attitudes and skills of individual healthcare providers.
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Affiliation(s)
- Mojca Ramšak
- Faculty of Medicine, Institute for History of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Katarzyna Bielińska
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Anna Chowaniec
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Robert Doričić
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Marianne Nowak
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Tobias Skuban-Eiseler
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Ivana Tutić Grokša
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Paweł Łuków
- Faculty of Philosophy, Center for Bioethics and Biolaw, University of Warsaw, Warszawa, Poland
| | - Amir Muzur
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Zvonka Zupanič-Slavec
- Faculty of Medicine, Institute for History of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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Khan AM, Lin P, Kamdar N, Mahmoudi E, Clarke P. Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context. DISABILITIES (BASEL, SWITZERLAND) 2023; 3:295-306. [PMID: 38223395 PMCID: PMC10786460 DOI: 10.3390/disabilities3020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Continuity of care is considered a key metric of quality healthcare. Yet, continuity of care in adults aging with congenital disability and the factors that contribute to care continuity are largely unknown. Using data from a national private administrative health claims database in the United States (2007-2018). we examined continuity of care in 8596 adults (mean age 48.6 years) with cerebral palsy or spina bifida. Logistic regression models analyzed how proximity to health care facilities, availability of care providers, and community socioeconomic context were associated with more continuous care. We found that adults aging with cerebral palsy or spina bifida saw a variety of different physician specialty types and generally had discontinuous care. Individuals who lived in areas with more hospitals and residential care facilities received more continuous care than those with limited access to these resources. Residence in more affluent areas was associated with receiving more fragmented care. Findings suggest that over and above individual factors, community healthcare resources and socioeconomic context serve as important factors to consider in understanding continuity of care patterns in adults aging with cerebral palsy or spina bifida.
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Affiliation(s)
- Anam M. Khan
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, USA
| | - Paul Lin
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA
| | - Neil Kamdar
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Disability Health and Wellness, University of Michigan, Ann Arbor, MI 48108, USA
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elham Mahmoudi
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Disability Health and Wellness, University of Michigan, Ann Arbor, MI 48108, USA
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Rade BK, Tamiru AT, Aynalem GL, Taye EB, Melkie M, Abera A, Cherkos EA, Asaye MM. Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study. BMC Womens Health 2023; 23:215. [PMID: 37131161 PMCID: PMC10155295 DOI: 10.1186/s12905-023-02373-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND According to International Convention on the Right of Person with Disabilities (CRPD), all nations should discern Sexual and Reproductive Health (SRH) as human rights and needs of all people living with disabilities. Women and girls with disabilities are highly vulnerable to SRH disparities including unintended pregnancy, acquiring sexual transmitted infections and unsafe abortion. Little has known about SRH service uptake and influencing factors among reproductive aged women living with disabilities. METHODS A community-based cross-sectional study was conducted from January 1-30, 2021, the central Gondar zone selected districts. A total of 535 reproductive-age (18-49 years) women with disabilities had been interviewed through face-to-face using structured questionnaire. Multistage cluster sampling method was applied. A binary logistic regression model was computed to look the relationship between independent variables and uptake of SRH, and p-value < 0.05 was a cut-off point to declare statistical significance. RESULTS A total of 33.27% (178/535) women with disabilities used at least one SRH service in the last twelve months preceding the survey. Those who had three or more children [AOR = 4.85; 95% CI (1.24-9.71)], autonomy to visit health care facilities [AOR = 3.30; 95% CI (1.45-6.92)], lived with sexual partner [AOR = 9.2; 95% CI (2.84-13.60)], subjected to radio/television in daily bases [AOR = 5.9; 95% CI (1.26-13.04)], autonomy to visit friends and relatives [AOR = 3.95; 95% CI (1.28-12.17)], had a discussion with family members about sexual and reproductive health [AOR = 9.36; 95% CI (3.44-17.47)], and engaged in sexual activity after the age of 18 years [AOR = 7.2; 95% CI (2.51-14.45)] were important predictors for service uptake. CONCLUSIONS Only one in three reproductive age women with disabilities used at least one SRH service. These findings suggest that accessing information through mainstream media exposure, having full autonomous to visit friends and families, open discussion with family members, live with sexual partner, having optimal family size and starting sexual act at the recommended age improve the uptake of SRH services. Therefore, the stakeholders (both governmental and non-governmental) need to make efforts to increase the uptake of SRH services.
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Affiliation(s)
- Bayew Kelkay Rade
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
| | - Animut Tagele Tamiru
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Eden Bishaw Taye
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkie
- Department of Special Need, College of Social Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Endeshaw Admassu Cherkos
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Mengstu Melkamu Asaye
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. “Sex Should Not be Part of the Lives of Persons with Disabilities, but They Are Human Beings too”: Perceptions of Healthcare Providers and Factors Affecting Service Delivery in Ghana. Healthcare (Basel) 2023; 11:healthcare11071041. [PMID: 37046968 PMCID: PMC10093840 DOI: 10.3390/healthcare11071041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
Persons with disabilities (PwDs) constitute about 16% of the global population and face many challenges in every society, including access to sexual and reproductive healthcare. The attitudes of healthcare providers (HPs) exert a major influence on PwDs accessing sexual and reproductive healthcare (SRH). A sequential explanatory mixed methods design was used to investigate the attitudes and perceptions of HPs towards PwDs and SRH delivery in Ghana’s Ashanti region. Quantitative data analysis indicated that overall, 82% of HPs had received information on disability-related issues and had relatively positive attitude towards PwDs, which varied across sub-scales of the Attitude Towards Disability score and associated with their sociodemographic characteristics. HPs faced several challenges in SRH services delivery to PwDs, which included a lack of funding and training, and inadequate staff. Inductive thematic analysis of the qualitative data revealed eight overarching themes. The findings revealed that HPs had prejudice about the mental and sexual health abilities of PwDs. Inadequate skill set, inadequate resources, and limited funding were major challenges identified. Nonetheless, compassion and benevolence towards PwDs, improvision, economic and educational support, awareness creation, and referrals were strategies adopted to overcome these challenges. Mandatory training of HPs is recommended to ensure improved SRH service delivery to PwDs. Future research could explore the perceptions and coping strategies of PwDs.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Department of Population and Health, University of Cape Coast, Cape Coast P.O. Box UC 182, Ghana
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Kristin McBain-Rigg
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | | | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD 4811, Australia
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Parekh T, Gimm G, Kitsantas P. Sexually Transmitted Infections in Women of Reproductive Age by Disability Type. Am J Prev Med 2023; 64:393-404. [PMID: 36528453 DOI: 10.1016/j.amepre.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The objectives of this study were to estimate the prevalence of sexually transmitted infections in women of reproductive age by disability type and examine the association between disability types, participant characteristics, and the prevalence of sexually transmitted infections (STIs). METHODS Pooled data from 2015 to 2019 National Survey on Drug Use and Health were analyzed in 2022. The analytic sample included 90,233 women of reproductive age (18-49 years). Disability was defined as having any sensory, cognitive, physical, or ≥2 disabilities.. A total of 15% of women reported having a disability. Descriptive analyses were used to estimate the prevalence of STI, and logistic regression analyses were conducted to examine the association of disability type and other participant characteristics with the odds of having STIs. RESULTS The prevalence of STIs was more than twice as high for women of reproductive age with cognitive disabilities (6.8%) or ≥2 disabilities (6.7%) as for those without disabilities (2.7%). Women with sensory disabilities (AOR=1.47; 95% CI=1.17, 1.85), cognitive disabilities (AOR=1.89; 95% CI=1.65, 2.17), or ≥2 disabilities (AOR=1.78; 95% CI=1.49, 2.14) had greater odds of STIs than those without disabilities. Bisexual women had higher odds (AOR=1.31; 95% CI=1.14, 1.50) of STIs than straight women, whereas lesbian/gay women had lower odds (AOR=0.41; 95% CI=0.27, 0.63). The odds of STIs were higher among non-Hispanic Blacks (AOR=1.42; 95% CI=1.24, 1.63) and lower among Asian women (AOR=0.62; 95% CI=0.43, 0.90) than among non-Hispanic Whites. The odds of STIs were also greater among participants having any alcohol, cannabis, or illicit drug use. CONCLUSIONS Women of reproductive age with disabilities have a higher prevalence of sexually transmitted infections. In addition to disability type, the odds of sexually transmitted infections varied by race/ethnicity, sexual orientation, and substance use.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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Pinilla-Roncancio M. Multidimensional Measures and the Extra Costs of Disability: How Are They Related? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2729. [PMID: 36768094 PMCID: PMC9916346 DOI: 10.3390/ijerph20032729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
People with disabilities are more likely than individuals without disabilities to face higher levels of deprivation and multidimensional poverty, and those deprivations might be associated with the extra costs of living with a disability. However, there has not been an analysis of how multidimensional poverty measures are related to the extra costs of disability or whether these measures can be used as a proxy of the standard of living in the analysis of the extra costs of disability. This paper aims to analyse whether multidimensional poverty measures can be used to study the extra costs of disability and, based on the capability approach, how multidimensional poverty is related to the extra costs of disability. This paper discusses theoretical, technical, and methodological aspects to be considered when studying the relationship between extra costs and multidimensional poverty, and we used data from Chile and Nigeria to illustrate this relationship. We conclude that when analysing the extra costs of disability, multidimensional measures might be an option; however, it is necessary to clearly stablish the relationship among income, deprivation, and the extra costs of disability.
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Skuban-Eiseler T, Orzechowski M, Steger F. Access to healthcare for disabled individuals: An analysis of judgments of the European Court of Human Rights from an ethical perspective. Front Public Health 2023; 10:1015401. [PMID: 36703847 PMCID: PMC9871461 DOI: 10.3389/fpubh.2022.1015401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Individuals with disabilities (ID) suffer from restricted access to healthcare. This contributes to their poorer health status and constitutes an ethical challenge. The aim of this research was to systematically analyze judgments of the European Court of Human Rights (ECtHR) to illustrate examples of restricted access to healthcare for ID. Methods Through a search in the ECtHR's database we identified judgments dealing with access to healthcare for ID. The search resulted in n = 329 judgments, of which n = 55 were included in the analysis. A descriptive statistic was performed on Articles of the European Convention on Human Rights and violation of these articles. Qualitative thematic analysis was conducted to group the judgments in thematic categories. Results Most applications were filed against Russia (n = 23), followed by Poland (n = 8) and Ukraine (n = 7). The youngest applicant was 18, the oldest 72 years old. An overwhelming majority of cases dealt with disabled prisoners. Most of the judgments involved Article 14 and Article 8. We identified seven partially overlapping categories representing thematic patterns in the analyzed judgments. Discussion Any restriction of access to healthcare can be considered a violation of human rights. However, the results show a relatively low total number of judgments dealing with limited access to healthcare for ID. This could be a further confirmation of the fact that ID still experience too little attention in our societies. Especially in the context of detention, ID is restricted from receiving the healthcare they require. Indirect ways of a restricted access to healthcare should not be overseen.
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Affiliation(s)
- Tobias Skuban-Eiseler
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany,kbo-Isar-Amper-Klinikum Region München, München-Haar, Germany,*Correspondence: Tobias Skuban-Eiseler ✉
| | - Marcin Orzechowski
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Florian Steger
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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Zirra A, Rao SC, Bestwick J, Rajalingam R, Marras C, Blauwendraat C, Mata IF, Noyce AJ. Gender Differences in the Prevalence of Parkinson's Disease. Mov Disord Clin Pract 2022; 10:86-93. [PMID: 36699001 PMCID: PMC9847309 DOI: 10.1002/mdc3.13584] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/03/2022] [Indexed: 01/28/2023] Open
Abstract
Background Parkinson's disease (PD) affects males more than females. The reasons for the gender differences in PD prevalence remain unclear. Objective The objective of this systematic review and meta-analysis was to update the overall male/female prevalence ratios (OPR). Methods We updated previous work by searching MEDLINE, SCOPUS, and OVID for articles reporting PD prevalence for both genders between 2011 and 2021. We calculated OPRs and investigated heterogeneity in effect estimates. Results We included 19 new articles and 13 articles from a previously published meta-analysis. The OPR was 1.18, 95% CI, [1.03, 1.36]. The OPR was lowest in Asia and appeared to be decreasing over time. Study design, national wealth, and participant age did not explain OPR heterogeneity. Conclusion Gender differences in PD prevalence may not be as stark as previously thought. Studies are needed to understand the role of other determinants of gender differences in PD prevalence.
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Affiliation(s)
- Alexandra Zirra
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | - Shilpa C. Rao
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Jonathan Bestwick
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | | | - Connie Marras
- University Health NetworkUniversity of TorontoTorontoOntarioCanada
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute of AgingNational Institutes of HealthBethesdaMarylandUSA
| | - Ignacio F. Mata
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Alastair J. Noyce
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom,Department of Clinical and Movement NeurosciencesUCL Institute of NeurologyLondonUnited Kingdom
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Comprehensive Senior Technology Acceptance Model of Daily Assistive Technology for Older Adults with Frailty: Cross-Sectional Study (Preprint). J Med Internet Res 2022; 25:e41935. [PMID: 37036760 PMCID: PMC10131916 DOI: 10.2196/41935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/31/2023] [Accepted: 02/26/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND There are considerable gaps between the need for assistive technologies and the actual adoption of these technologies among older adults, although older adults are among the groups that most need assistive technologies. Consequently, research is needed in this area because older adults' technology acceptance and influencing factors may differ depending on their level of frailty. OBJECTIVE The objective of this study was to compare frail, prefrail, and robust groups of South Korean adults regarding their behavioral intention to use daily living assistive technologies and the affecting factors-namely, technological context factors, health contexts and abilities, and attitudinal factors-based on a comprehensive senior technology acceptance model. METHODS A nationwide sample of 500 older South Korean adults (aged 55-92 years) was analyzed, and multivariate linear regression analyses of the robust, prefrail, and frail groups were performed. The independent and dependent variables consisted of 3 factors based on previous studies. First, technological context factors consisted of gerontechnology self-efficacy, gerontechnology anxiety, and facilitating conditions. Second, health contexts and abilities consisted of self-reported health conditions, cognitive ability, social relationships, psychological function, and physical function. Third and last, attitudinal factors consisted of behavioral intention to use assistive technologies, attitude toward use, perceived usefulness (PU), and perceived ease of use (PEOU). RESULTS The results of the analyses showed that technological context factors such as gerontechnology self-efficacy, health contexts and abilities such as self-reported health conditions and psychological function, and attitudinal factors such as attitude toward use, PU, and PEOU had significant effects on behavioral intention to use daily living assistive technologies. In particular, gerontechnology self-efficacy had a significant relationship with behavioral intention to use these technologies in the robust (r=0.120; P=.03) and prefrail (r=0.331; P<.001) groups. Psychological function (life satisfaction) had a significant relationship with behavioral intention to use these technologies in the robust group (r=-0.040; P=.02). Self-reported health conditions had a significant relationship with behavioral intention to use these technologies in the prefrail group (r=-0.169; P=.01). Although each group had a different significant relationship with the variables, attitudinal factors such as attitude toward use affected all groups (robust group: r=0.190; P=.03; prefrail group: r=0.235; P=.006; and frail group: r=0.526; P=.002). In addition, PU and PEOU in the attitudinal factors had a significant relationship with behavioral intention to use assistive technologies in the robust (PU: r=0.160; P=.01; and PEOU: r=0.350; P<.001) and prefrail (PU: r=0.265; P<.001; and PEOU: r=0.120; P=.04) groups. CONCLUSIONS This study found that the comprehensive senior technology acceptance model of daily living assistive technologies had different associations according to the frailty group. These findings provided insights into the consideration of interventions with daily living assistive technologies for older adults with varying levels of frailty.
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Chan DN, Law BM, So WK, Fan N. Factors associated with cervical cancer screening utilisation by people with physical disabilities: A systematic review. Health Policy 2022; 126:1039-1050. [DOI: 10.1016/j.healthpol.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 04/29/2022] [Accepted: 08/02/2022] [Indexed: 12/01/2022]
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Chaiban L, Benyaich A, Yaacoub S, Rawi H, Truppa C, Bardus M. Access to primary and secondary health care services for people living with diabetes and lower-limb amputation during the COVID-19 pandemic in Lebanon: a qualitative study. BMC Health Serv Res 2022; 22:593. [PMID: 35505335 PMCID: PMC9063244 DOI: 10.1186/s12913-022-07921-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background People living with chronic conditions and physical disabilities face many challenges accessing healthcare services. In Lebanon, in 2020, the COVID-19 pandemic and concomitant economic crisis further exacerbated the living conditions of this segment of the population. This study explored the barriers to accessing healthcare services among people living with diabetes and lower-limb amputation during the pandemic. Methods We conducted semi-structured, in-depth phone interviews with users of the Physical Rehabilitation Program, offered by the International Committee of the Red Cross. We used a purposive sampling technique to achieve maximum variation. Interviews were audio-recorded, transcribed, translated, and analyzed using thematic analysis following the “codebook” approach. Transcripts were coded and grouped in a matrix that allowed the development of themes and sub-themes inductively and deductively generated. Results Eight participants (7 males, 1 female) agreed to be interviewed and participated in the study between March and April, 2021. Barriers to healthcare services access were grouped according to five emerging themes: (1) economic barriers, included increasing costs of food, health services and medications, transportation, shortage of medications, and limited income; (2) structural barriers: availability of transportation, physical environment, and service quality and availability; (3) cultural barriers: marginalization due to their physical disabilities; favoritism in service provision; (4) personal barriers: lack of psychosocial support and limited knowledge about services; (5) COVID-19 barriers: fear of getting sick when visiting healthcare facilities, and heightened social isolation due to lockdowns and physical distancing. Conclusion The underlying economic crisis has worsened the conditions of people living with diabetes and lower-limb amputation. The pandemic has made these individuals more vulnerable to external and contextual factors that cannot be addressed only at an individual level. In the absence of a protective legal framework to mitigate inequalities, we provide recommendations for governments and nongovernmental institutions to develop solutions for more equitable access to healthcare for this segment of the population. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07921-7.
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Affiliation(s)
- Lea Chaiban
- American University of Beirut, Beirut, Lebanon
| | - Aicha Benyaich
- International Committee of the Red Cross (ICRC), Jeanne D'Arc 326 Building, Sidani Street, Hamra, Beirut, Lebanon
| | - Sally Yaacoub
- International Committee of the Red Cross (ICRC), Jeanne D'Arc 326 Building, Sidani Street, Hamra, Beirut, Lebanon.
| | - Haya Rawi
- International Committee of the Red Cross (ICRC), Jeanne D'Arc 326 Building, Sidani Street, Hamra, Beirut, Lebanon
| | - Claudia Truppa
- International Committee of the Red Cross (ICRC), Jeanne D'Arc 326 Building, Sidani Street, Hamra, Beirut, Lebanon.,CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Novara, Italy
| | - Marco Bardus
- School of Health, Sport, and Life Sciences, Leeds Trinity University, Horsforth, Leeds, UK.,Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
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Saeed G, Brown HK, Lunsky Y, Welsh K, Proulx L, Havercamp S, Tarasoff LA. Barriers to and facilitators of effective communication in perinatal care: a qualitative study of the experiences of birthing people with sensory, intellectual, and/or developmental disabilities. BMC Pregnancy Childbirth 2022; 22:364. [PMID: 35473673 PMCID: PMC9044670 DOI: 10.1186/s12884-022-04691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Effective provider-patient communication is a key element of quality health care, including perinatal care. What constitutes "effective communication" in perinatal care may vary according to the population seeking care, such as women with intellectual and developmental disabilities (IDD) and sensory disabilities. Research broadly indicates that communication issues are among the barriers to perinatal care experienced by women with disabilities. However, few studies have explicitly explored their communication experiences in this context. The purpose of this study was to understand the communication experiences of birthing people with IDD and/or sensory disabilities in perinatal care. METHODS We conducted semi-structured interviews with 17 people with IDD (e.g., autism, cognitive delay) and/or sensory disabilities (e.g., d/Deaf, blind) in Ontario, Canada, who had recently given birth, to explore barriers to and facilitators of effective communication in perinatal care. A combination of deductive and inductive thematic analysis guided data analysis. RESULTS We found that birthing people with IDD and/or sensory disabilities encountered multiple barriers to effective communication in perinatal care, namely, lack of policies and guidelines, lack of provider experience, lack of provider effort, as well as ableism and provider assumptions. Facilitators included knowledgeable, aware, and supportive providers; access to communication aids and services; tailoring information to patients' disability-related communication needs; empathic communication; and, communication among providers. CONCLUSION Unmet communication needs may contribute to negative health and social outcomes for birthing people with disabilities and their newborns. Accessibility policy implementation and practice change are needed to meet the communication needs of people with IDD and/or sensory disabilities in perinatal care to ensure positive experiences and outcomes.
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Affiliation(s)
- Gul Saeed
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
- Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada.
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Kate Welsh
- Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
| | - Laurie Proulx
- Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
| | - Susan Havercamp
- Nisonger Center, The Ohio State University, McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210-1257, USA
| | - Lesley A Tarasoff
- Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
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Gold JI, Gold NB, DeLeon DD, Ganetzky R. Contraceptive use in women with inherited metabolic disorders: a retrospective study and literature review. Orphanet J Rare Dis 2022; 17:41. [PMID: 35135572 PMCID: PMC8822780 DOI: 10.1186/s13023-022-02188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reproductive planning is an emerging concern for women with inherited metabolic disease (IMD). Anticipatory guidance on contraception is necessary to prevent unintended pregnancies in this population. Few resources exist to aid informed decision-making on contraceptive choice. A retrospective case-control study was performed to examine trends in reproductive planning for adolescent and adult women seen at the Children's Hospital of Philadelphia (CHOP). Literature review on contraception and IMD was performed to assess global use. RESULTS In a cohort of 221 reproductive-aged female IMD patients, 29.4% reported routine contraceptive use. Anticipatory guidance on contraception was provided by metabolic physicians to 36.8% of patients during the study period. Contraception discussion was more likely to occur in women older than 21 years, who lived independently and were followed by gynecology. Women who received contraception counseling from their metabolic physician were 40-fold more likely to use regular contraception. Use of combined hormonal contraceptives was most commonly reported, but contraception choice varied by age and IMD. CONCLUSION Metabolic physicians are ideally suited to provide guidance on contraception to women with IMD. Reproductive planning should be addressed routinely using shared decision-making. Contraceptives should be selected for their efficacy, effects on metabolism, and likelihood of patient adherence.
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Affiliation(s)
- Jessica I Gold
- Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Nina B Gold
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Diva D DeLeon
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Hughes RB, Beers L, Robinson-Whelen S. Health Information Seeking by Women with Physical Disabilities: A Qualitative Analysis. Disabil Health J 2022; 15:101268. [PMID: 35123921 PMCID: PMC8983536 DOI: 10.1016/j.dhjo.2022.101268] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/21/2021] [Accepted: 12/30/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Health information seeking is critical to medical decision-making and optimal health. Although researchers have begun to explore how people with disabilities search for health information, no studies have investigated health information seeking by women with physical disabilities. OBJECTIVE The purpose of this qualitative study was to examine the health information seeking experiences of women with physical disabilities. METHOD We conducted a series of semi-structured, online focus group meetings with 21 women with disabilities. Sessions were recorded and transcribed, and data were analyzed using conventional content analysis. RESULTS Two broad themes emerged: 1) pathways to information on general health; sexual and reproductive health; as well as bowel, bladder, and other pelvic health issues; and 2) perceived facilitators and barriers to obtaining health information. Information pathways differed by the type of information sought. Internet was a commonly used resource, with a high value placed on social media interaction among peers. Self-advocacy emerged as a prominent facilitator of health information seeking. Barriers identified were lack of disability-related education, limited accessibility, and providers' negative attitudes. CONCLUSION This is the first known in-depth qualitative exploration of health information seeking by women with disabilities. Study findings revealed pathways to information commonly used by women with disabilities. The study also identified notable gaps and challenges to health information seeking including the need for improved provider education and training. Findings highlight the importance of the availability and accessibility of high quality, health-related information essential for the health and well-being of women with disabilities.
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Affiliation(s)
- Rosemary B Hughes
- University of Montana, Rural Institute for Inclusive Communities, Missoula, MT 59812, USA.
| | - Leanne Beers
- University of Montana, Rural Institute for Inclusive Communities, Missoula, MT 59812, USA
| | - Susan Robinson-Whelen
- Baylor College of Medicine, Department of Physical Medicine and Rehabilitation, Center for Research on Women with Disabilities, One Baylor Plaza, Houston, TX 77030, USA; TIRR Memorial Hermann, Spinal Cord Injury and Disability Research Center, 1333 Moursund St., Houston, TX 77030, USA
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45
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Atkinson HG, Wyka K, Hampton K, Seno CL, Yim ET, Ottenheimer D, Arastu NS. Impact of forensic medical evaluations on immigration relief grant rates and correlates of outcomes in the United States. J Forensic Leg Med 2021; 84:102272. [PMID: 34743036 DOI: 10.1016/j.jflm.2021.102272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the impact of forensic medical evaluations on grant rates for applicants seeking immigration relief in the United States (U.S.) and to identify significant correlates of grant success. We conducted a retrospective analysis of 2584 cases initiated by Physicians for Human Rights between 2008 and 2018 that included forensic medical evaluations, and found that 81.6% of applicants for various forms of immigration relief were granted relief, as compared to the national asylum grant rate of 42.4%. Among the study's cohort, the majority (73.7%) of positive outcomes were grants of asylum. A multivariable regression analysis revealed that age, continent of origin, history of sexual or gender-based violence, gang violence, LGB sexual orientation, and being detained by the U.S. government at the time of evaluation request were statistically associated with case outcomes. Forensic physical evaluation was more strongly associated with a positive outcome than forensic psychological evaluation. Our findings strengthen and expand prior evidence that forensic medical evaluations can have a substantial positive impact on an applicant's immigration relief claim. Given the growing applicant pool in the U.S., there is an urgent need for more trained clinicians to conduct forensic medical evaluations as well as to educate adjudicators, immigration lawyers, and policy makers about the traumatic nature of the life-altering events that applicants for immigration relief experience.
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Affiliation(s)
- Holly G Atkinson
- CUNY School of Medicine, 160 Convent Avenue, Harris Hall, Suite 113, New York, NY, 10031, USA.
| | - Katarzyna Wyka
- Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, 55 W. 125th Street, Room 805, New York, NY, 10027, USA.
| | - Kathryn Hampton
- Physicians for Human Rights, 256 W. 38th St., Ninth Floor, New York, NY, 10018, USA.
| | - Christian L Seno
- Managing Editor, CUNY Law Review, CUNY School of Law, Two Court Square, Long Island City, NY, 11101, USA.
| | - Elizabeth T Yim
- CUNY School of Medicine, 160 Convent Avenue, Harris Hall, Suite 113, New York, NY, 10031, USA.
| | - Deborah Ottenheimer
- Women's Health Services, Gotham Health, Morrisania, 1225 Gerard Avenue, 3rd Floor, Bronx, NY, 10452, USA.
| | - Nermeen S Arastu
- Immigrant & Non-Citizen Rights Clinic, CUNY School of Law, Two Court Square, Long Island City, NY, 11101-4356, USA.
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Asa GA, Fauk NK, Mwanri L, Ward PR. Understanding Barriers to the Access to Healthcare and Rehabilitation Services: A Qualitative Study with Mothers or Female Caregivers of Children with a Disability in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111546. [PMID: 34770060 PMCID: PMC8583444 DOI: 10.3390/ijerph182111546] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022]
Abstract
Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball sampling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.
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Affiliation(s)
| | - Nelsensius Klau Fauk
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
- Institute of Resource Governance and Social Change, Kupang 85221, Indonesia
- Correspondence:
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
| | - Paul Russell Ward
- College of Medicine and Public Health, Flinders University, P.O. Box 2100, Adelaide 5001, Australia; (L.M.); (P.R.W.)
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Downing KF, Oster ME, Klewer SE, Rose CE, Nembhard WN, Andrews JG, Farr SL. Disability Among Young Adults With Congenital Heart Defects: Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being 2016-2019. J Am Heart Assoc 2021; 10:e022440. [PMID: 34666499 PMCID: PMC8751822 DOI: 10.1161/jaha.121.022440] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Disabilities have implications for health, well‐being, and health care, yet limited information is available on the percentage of adults with congenital heart defects (CHD) living with disabilities. We evaluated the prevalence of disability and associated characteristics among the 2016–2019 CH STRONG (Congenital Heart Survey to Recognize Outcomes, Needs, and Well‐Being) population‐based sample of 19‐ to 38‐year‐olds with CHD from 3 US locations. Methods and Results Prevalence of disability types (hearing, vision, cognition, mobility, self‐care, living independently) were compared with similarly aged adults from the general population as estimated by the American Community Survey and standardized to the CH STRONG eligible population to reduce nonresponse bias and confounding. Health‐related quality of life (HRQOL) was measured via Patient‐Reported Outcomes Measurement Information System Global Health Scale T‐scores standardized to US 18‐ to 34‐year‐olds. Separate multivariable regression models assessed associations between disability and HRQOL. Of 1478 participants, 40% reported disabilities, with cognition most prevalent (29%). Of those reporting disability, 45% ever received disability benefits and 46% were unemployed. Prevalence of disability types were 5 to 8 times higher in adults with CHD than the general population. Those with ≥1 disability had greater odds of being female, and of having non‐Hispanic Black maternal race and ethnicity, severe CHD, recent cardiac care, and noncardiac congenital anomalies. On average, adults with CHD and cognition, mobility, and self‐care disabilities had impaired mental HRQOL and those with any disability type had impaired physical HRQOL. Conclusions Two of 5 adults with CHD may have disabilities, which are associated with impaired HRQOL. These results may inform healthcare needs and services for this growing population.
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Affiliation(s)
- Karrie F Downing
- National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA
| | - Matthew E Oster
- National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA.,Children's Healthcare of Atlanta and Emory University School of Medicine Atlanta GA
| | - Scott E Klewer
- Department of Pediatrics University of Arizona Tucson AZ
| | - Charles E Rose
- National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA
| | - Wendy N Nembhard
- Department of Epidemiology Fay W Boozman College of Public Health and the Arkansas Center for Birth Defects Research and Prevention University of Arkansas for Medical Sciences Little Rock AR
| | | | - Sherry L Farr
- National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta GA
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Parry M, Bjørnnes AK, Harrington M, Duong M, El Ali S, O’Hara A, Clarke H, Cooper L, Hart D, Harvey P, Lalloo C, McFetridge-Durdle J, McGillion MH, Norris C, Pilote L, Price J, Stinson J, Watt-Watson J. “Her Heart Matters”—Making Visible the Cardiac Pain Experiences of Women with Physical Disabilities and Heart Disease: A Qualitative Study. CJC Open 2021; 4:214-222. [PMID: 35198939 PMCID: PMC8843888 DOI: 10.1016/j.cjco.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background Women with physical disabilities are faced with challenges in many aspects of life—education, work, income, relationships, as well as their general health. These women are at a greater risk of developing heart disease. This study aimed to explore the cardiac pain experiences of women with physical disabilities and heart disease within a Canadian healthcare context. Methods In this qualitative study, 8 women with physical disabilities and heart disease from across Canada were interviewed. They were asked about their pre-, peri-, and post-diagnostic experiences in the Canadian healthcare system. Transcripts of the interviews were analyzed using a hermeneutic phenomenological approach inspired by Ricoeur. Results Two main themes were uncovered in the analysis of the transcripts, as follows: (i) the diagnostic journey; and (ii) life with cardiac symptoms and a disability. The women indicated that they had experienced difficulties in utilizing the Canadian healthcare system prior to receiving a cardiac diagnosis, including long waitlists, expensive and unreliable transport, issues with accessibility, and dealing with providers’ attitudinal barriers regarding disability. Receiving a diagnosis was challenging due to poor relationships with healthcare providers; however, having a same-sex provider seemed essential to receiving adequate care. Self-managing a disability and heart disease had significant physical and psychological impact, which was lightened by financial and social supports, modified lifestyle choices, and self-advocacy. Conclusions Women with physical disabilities are often forgotten in discussions encompassing equity and inclusion. The participants’ experiences offer insight into what changes are needed within the Canadian healthcare system in order to improve outcomes for these women.
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