Toor Gurjit K, Harris Jocelyn E, Escobar Michael, Yoshida Karen, Velikonja Diana, Rizoli Sandro, Cusimano Michael, Cullen Nora, Sokoloff Sandra, Colantonio Angela
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
Arch Phys Med Rehabil. 2016 Feb;97(2 Suppl):S54-63. doi: 10.1016/j.apmr.2015.02.010. Epub 2015 Feb 20.
To (1) assess long-term health care service utilization and satisfaction with health care services among women with traumatic brain injury (W-TBI); (2) examine barriers that prevent W-TBI from receiving care when needed; and (3) understand the perceived supports available for W-TBI.
Retrospective cohort study.
Community.
W-TBI (n=105) 5 to 12 years postinjury and women without TBI (n=105) matched on age, education, and geographic location.
Not applicable.
Pre- and postinjury data were collected using a questionnaire administered via a semistructured interview. Questions on health services utilization, satisfaction with and quality of services, barriers to receiving care, and perceived social support were from the Canadian Community Health Survey; additional questions on perceived social support were from another large-scale study of people with moderate to severe brain injury.
Compared with women without TBI, W-TBI reported using more family physician and community health services. W-TBI reported that they did not receive care when needed (40%), particularly for emotional/mental health problems. Significantly more W-TBI reported financial and structural barriers. There were no significant differences in reported satisfaction with services between women with and without TBI.
Health service providers and policymakers should recognize the long-term health and social needs of W-TBI and address societal factors that result in financial and structural barriers, to ensure access to needed services.
(1)评估创伤性脑损伤女性(W-TBI)的长期医疗服务利用情况以及对医疗服务的满意度;(2)检查阻碍W-TBI在需要时获得护理的障碍;(3)了解W-TBI可获得的感知支持。
回顾性队列研究。
社区。
受伤后5至12年的W-TBI患者(n = 105)以及在年龄、教育程度和地理位置上匹配的无创伤性脑损伤女性(n = 105)。
不适用。
通过半结构化访谈使用问卷收集受伤前后的数据。关于医疗服务利用、对服务的满意度和质量、接受护理的障碍以及感知社会支持的问题来自加拿大社区健康调查;关于感知社会支持的其他问题来自另一项对中重度脑损伤患者的大规模研究。
与无创伤性脑损伤的女性相比,W-TBI报告使用了更多的家庭医生和社区健康服务。W-TBI报告称他们在需要时未获得护理(40%),尤其是在情感/心理健康问题方面。显著更多的W-TBI报告了经济和结构障碍。有创伤性脑损伤和无创伤性脑损伤的女性在报告的服务满意度方面没有显著差异。
医疗服务提供者和政策制定者应认识到W-TBI的长期健康和社会需求,并解决导致经济和结构障碍的社会因素,以确保获得所需服务。