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Zhou L, Li Y, Zhang Y, Chen X, Zhang S, Hu X. Perceptions of Telehealth Services Among Rural Lung Cancer Patients in China: A Qualitative Study Using the Technology Acceptance Model. Semin Oncol Nurs 2024:151710. [PMID: 39117510 DOI: 10.1016/j.soncn.2024.151710] [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: 01/15/2024] [Revised: 06/25/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVES To describe the perceptions of telehealth services among lung cancer patients in rural areas of China, as well as to explore the potential of telemedicine to improve long-term health recovery at home for rural lung cancer patients. METHODS A qualitative descriptive study design was used in this study and we conducted semi-structured interviews with 14 rural Chinese lung cancer patients between December 2022 and March 2023. Interview content was analyzed using Nvivo software and a framework analysis was performed using the Technology Acceptance Model to identify meaningful themes. RESULTS Participants identified perceptual and technical factors related to perceived ease of use, benefits and drawbacks related to perceived usefulness, and facilitators and barriers related to intention to use. However, regional and disease features including literacy barriers, medical insurance condition, symptom burden, and rural cultural health seeking behavior conduct must be taken into account. CONCLUSIONS Lung cancer patients in rural China believe that telehealth services could be an alternative solution for addressing health and care needs, but various aspects, such as user interface design, cost-effectiveness, and technological anxiety, need to be optimized. IMPLICATIONS FOR NURSING PRACTICE More highly specialized nursing team, friendly telecare lung function modules, and media technology training courses should be developed for rural lung cancer patients to enhance the quality of their home care, meet their information needs and better control their disease progression.
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Affiliation(s)
- Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China.
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Lin J, Yang D, Zhao X, Xie L, Xiong K, Hu L, Xu Y, Yu S, Huang W, Gong N, Liang X. The action logic of the older adults about health-seeking in South Rural China. BMC Public Health 2023; 23:2487. [PMID: 38087231 PMCID: PMC10714459 DOI: 10.1186/s12889-023-17314-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. METHODS Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. RESULTS Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) 'unpredictable' troubles: they tended to favor the 'optimal' solution of keeping their lives in order rather than the best medical treatment options. CONCLUSION This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the 'inaccessibility' of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education.
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Affiliation(s)
- Jianqiang Lin
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dan Yang
- Department of Endodontics, Stomatological Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinyu Zhao
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Liqiong Xie
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kun Xiong
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Hu
- School of Nursing, Jinan University, Guangzhou, China
| | - Yue Xu
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - ShanShan Yu
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, China.
| | - Xiaoling Liang
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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Yuan D, Yang P, Yang H, Tang H, Guo C. Challenges and Responses of Left-Behind Elderly and Children in Rural China Amid the New Population Development Stage. China CDC Wkly 2023; 5:609-613. [PMID: 37476620 PMCID: PMC10354534 DOI: 10.46234/ccdcw2023.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023] Open
Affiliation(s)
- Dianqi Yuan
- Institute of Population Research, Peking University, Beijing, China
| | - Peisen Yang
- APEC Health Science Academy, Peking University, Beijing, China
| | - Hanbing Yang
- Institute of Population Research, Peking University, Beijing, China
| | - Huameng Tang
- Institute of Population Research, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China
- APEC Health Science Academy, Peking University, Beijing, China
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Chen L, Cheng M. Exploring Chinese Elderly's Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16461. [PMID: 36554341 PMCID: PMC9779095 DOI: 10.3390/ijerph192416461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
This research aims to investigate how much the Chinese elderly trust the healthcare system and the critical factors that influence their trust. We use data from the China Social Survey (CSS) collected by the Chinese Academy of Social Sciences in the year 2019 to examine how demographic factors, social-economic status, internet access, and perceptions of the healthcare system impact the Chinese elderly's trust in the healthcare system. Our research finds male gender, high educational level, and having internet access are negatively related to the elderly's trust in the healthcare system. Our research also reveals that the elderly's trust in the healthcare system was significantly related to their subjective perception of their social-economic status, upward mobility, and perception of accessibility and affordability rather than other objective indicators such as income and financial protection. The results imply that the elderly have a pessimistic expectation of their subjective social status and future possibilities of upward mobility in their later life, which deepens their distrust of the health system. Additionally, the accessibility and affordability of the healthcare system have remained problematic among the Chinese elderly. The study provides important theoretical and practical implications to enhance the elderly's trust in the healthcare system.
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Affiliation(s)
- Lu Chen
- School of Journalism and Communication, Guangzhou University, Guangzhou 510006, China
| | - Miaoting Cheng
- Department of Educational Technology, Faculty of Education, Shenzhen University, Shenzhen 518060, China
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Pan M, Huang Y, Qin Y, Li X, Lang W. Problems and Strategies of Allocating Public Service Resources in Rural Areas in the Context of County Urbanization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14596. [PMID: 36361477 PMCID: PMC9656279 DOI: 10.3390/ijerph192114596] [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: 10/10/2022] [Revised: 10/31/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Imbalances in allocating public service resources are a universal problem worldwide, especially in urban and rural areas. As a developing country with a significant imbalance between urban and rural areas, China is representative of the unbalanced allocation of public service resources. Presently, China has entered the county urbanization stage. Therefore, this study can provide a new way to realize the equalization of urban and rural public services with the county as the basic unit. Taking counties as the primary study area, this paper analyzes the new trends of population mobility in China's counties. It combines large-scale questionnaires and field surveys to investigate the new demand of rural residents for public services and the shortcomings of public service resource allocation. First, the county seat attracts a concentration of the county's rural residents and returning population, whose high expectations for the county seat's education and medical services have not yet been met. Second, the township assumes the vital function of elementary school education and medical services in rural areas, and the rural children have a great demand for elementary school education services in the township. However, there are still apparent shortcomings in support of teaching facilities and the quality of education services. Third, the problem of aging and hollowing out in rural areas is serious, and the education, medical and elderly service needs of left-behind children and the elderly are difficult to be guaranteed. Finally, this paper proposes targeted planning strategies and policy recommendations for allocating county public service resources at three levels based on the "county-town-village" hierarchy.
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Affiliation(s)
- Muzhe Pan
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
- China Regional Coordinated Development and Rural Construction Institute, Sun Yat-sen University, Guangzhou 510275, China
| | - Yaofu Huang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
- China Regional Coordinated Development and Rural Construction Institute, Sun Yat-sen University, Guangzhou 510275, China
| | - Yawen Qin
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
- China Regional Coordinated Development and Rural Construction Institute, Sun Yat-sen University, Guangzhou 510275, China
| | - Xun Li
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
- China Regional Coordinated Development and Rural Construction Institute, Sun Yat-sen University, Guangzhou 510275, China
| | - Wei Lang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
- China Regional Coordinated Development and Rural Construction Institute, Sun Yat-sen University, Guangzhou 510275, China
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Gholamzadeh S, Shaygan M, Naderi Z, Hosseini FA. Age discrimination perceived by hospitalized older adult patients in Iran: A qualitative study. Health Promot Perspect 2022; 12:45-55. [PMID: 35854844 PMCID: PMC9277281 DOI: 10.34172/hpp.2022.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 02/22/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The quality of care that older adult patients receive during hospitalization is directly associated with the perception, knowledge, and skills of the healthcare team. This qualitative study was conducted to explore the concept of age discrimination perceived by hospitalized older adult patients. Methods: The present exploratory qualitative study was conducted using conventional content analysis. The purposive sampling method was used to recruit participants and the sampling continued until data saturation. A total of 21 individuals comprising of 12 hospitalized older adult patients, 5 family caregivers, 3 nurses, and a physician were enrolled in the study. Data were collected through 21 face-to-face, semi-structured, in-depth interviews. Data were analyzed using the qualitative content analysis method as described by Elo and Kyngäs. Results: The analysis of the interview data resulted in 4 main categories, namely injustice perceptions, interactional injustice, procedural injustice, and organizational injustice. Conclusion: The findings of the study indicated that older adult patients perceive the occurrence of age discrimination by healthcare teams and inequalities in the provided care in hospitals. It is therefore important to address ageism and subsequent inequalities through short- and long-term policies and plans, as well as standardization and transformation of the present condition of hospitals to become an age-friendly environment.
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Affiliation(s)
- Sakineh Gholamzadeh
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Naderi
- Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Fahimeh Alsadat Hosseini
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168857. [PMID: 34444606 PMCID: PMC8394535 DOI: 10.3390/ijerph18168857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 01/18/2023]
Abstract
Maintaining people’s health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations.
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Ohta R, Sato M, Ryu Y, Kitayuguchi J, Maeno T, Sano C. What resources do elderly people choose for managing their symptoms? Clarification of rural older people's choices of help-seeking behaviors in Japan. BMC Health Serv Res 2021; 21:640. [PMID: 34217269 PMCID: PMC8254357 DOI: 10.1186/s12913-021-06684-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background Appropriate help-seeking behavior (HSB) that involves lay and professional care may moderate the usage of medical resources and promote good health, especially among the rural elderly. However, there is little evidence regarding the rural elderly’s HSB choices for mild symptoms. Therefore, this study attempts to bridge this gap. Methods The participants were patients living in rural areas and over the age of 65, who attended Japanese clinics and general hospitals. In Phase 1, monthly diaries and one-on-one interviews about their mild symptoms and HSB were used to establish HSB items and assess its content validity. Content analysis helped determine the items. In Phase 2, participants were asked to complete the list to measure HSB. The answers to the list and HSB mentioned in the diaries were compared to evaluate concurrent validity. Retests were conducted to examine the content’s reliability and test-retest reliability. Results Phase 1 included 267 participants (average age = 75.1 years, standard deviation [SD] = 4.3; 50.1% male). The diary collection rate was 97.6%. Of the participants, 70.4% used lay care and 25.4% used professional care. Content analysis identified eight types of lay care and four types of professional care. Phase 2 included 315 participants (average age = 77.7 years, SD = 8.27; 46.0% male). In terms of validity, the results of the list and the diaries were correlated (Spearman r 0.704; p < 0.001). The most common behavior with mild symptoms was consulting with primary care physicians, followed by self-care and using home medicine. The test-retest reliability for mild symptoms found kappa values of 0.836 for lay care and 0.808 for professional care. Conclusions The choices of HSB for mild symptoms clarified identified in this study have high validity and reliability. Therefore, it can be used to assess the relationships between HSB and health conditions and the effectiveness of health promotion on rural older people’s HSB. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06684-x.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida Daito-cho, Unnan City, Shimane Prefecture, Japan. .,Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
| | - Mikiya Sato
- Health Services Development and Research Center, University of Tsukuba, Tsukuba, Japan.,Health Services Center, Occupational Safety and Health Department, Human Resources Group, Sumitomo Heavy Industries, Ltd., Tokyo, Japan
| | - Yoshinori Ryu
- Community Care, Unnan City Hospital, 96-1 Iida Daito-cho, Unnan City, Shimane Prefecture, Japan
| | - Jun Kitayuguchi
- Physical Education and Medicine Research Center Unnan, Unnan, Shimane Prefecture, Japan
| | - Tetsuhiro Maeno
- Health Services Development and Research Center, University of Tsukuba, Tsukuba, Japan.,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo, Shimane Prefecture, Japan
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Zou X, Nie JB. Family vulnerability for sick older adults: An empirical ethics study. Nurs Ethics 2020; 28:603-613. [PMID: 33190589 DOI: 10.1177/0969733020964850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In China, the conventional family-based ageing care model is under pressure from social transitions, raising the question of whether and to what extent families are still capable of dealing with the care of the aged. OBJECTIVE This article examines the vulnerability and inadequacy of families to bear responsibility for the care of the aged against a backdrop of socioeconomic transformation and diminishing institutional support in rural China. RESEARCH DESIGN This article adopts an empirical ethical approach that integrates empirical investigation with ethical inquiry. PARTICIPANTS AND RESEARCH CONTEXT The empirical component of this article focuses on the lived experiences of caring for a wife and mother with dementia in one rural Chinese family, collected from a 6-month fieldwork study conducted at one primary hospital. ETHICAL CONSIDERATIONS Approval was obtained from the university ethics committee. FINDINGS The empirical study highlights a conflicted family process of managing and negotiating care that indicates the inadequacies and limited ability of families to deal with aged care tasks. In addition, inadequate structures and institutional deficiencies exacerbate the vulnerability of rural families and their inability to offer adequate care. CONCLUSION Acknowledging the vulnerability of families as ageing care providers, this article calls for a socially supported family care model for rural older people in China and also proposes policy recommendations.
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