Amoah Padmore Adusei, Koduah Adwoa Owusuaa, Gyasi Razak Mohammed
a Division of Graduate Studies and Asia Pacific Institute of Aging Studies , Lingnan University , Tuen Mun , Hong Kong (SAR).
b School of Nursing , The Hong Kong Polytechnic University , Hung Hom , Kowloon.
Int J Qual Stud Health Well-being. 2018 Dec;13(1):1435108. doi: 10.1080/17482631.2018.1435108.
Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana.
Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region.
Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions-that were both 'expected' and 'encouraged'- reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending 'unapproved' alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions.
A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.
尽管社会资本在许多发展中国家会影响与健康相关的决策和行为模式,但人们对其对医疗保健影响的细微差别关注甚少。本文探讨了联结型社会资本如何影响加纳住院患者的医疗服务提供情况。
采用半结构化深度访谈,并运用主题分析法对数据进行分析。在阿散蒂地区的三个公共卫生机构,对卫生专业人员以及住院患者的亲属和密友进行了访谈。
住院患者的亲属和密友是工具性支持的重要来源,比如提供膳食、洗衣服务、跑腿办事和经济援助,以及情感支持。这些功能既“在预期之内”又“受到鼓励”,减轻了卫生机构的负担,因为卫生机构显然资源有限,难以提供充分的护理。然而,住院患者的亲属有时会因向患者提供“未经批准”的替代护理等行为,无意中妨碍了高效的医疗服务提供。此外,由于生活条件恶劣,亲属在照顾患者健康和福祉的过程中面临健康风险。
必须为住院患者至少最直接的社会关系设计一个明确且合适的角色,以增强联结型社会资本对医疗服务提供的积极影响。