识别新西兰老年太平洋岛民的听力保健服务获取障碍：一项定性研究。
Identifying hearing care access barriers among older Pacific Island people in New Zealand: a qualitative study.
机构信息
Section of Audiology, University of Auckland, Auckland, New Zealand
Section of Audiology, University of Auckland, Auckland, New Zealand.
出版信息
BMJ Open. 2019 Aug 6;9(8):e029007. doi: 10.1136/bmjopen-2019-029007.
OBJECTIVES
Hearing loss is one of the most prevalent conditions affecting older people. In addition, there is little known about the factors influencing the uptake of hearing services among underserved communities. Our objective was to identify the barriers to accessing hearing care services among older Pacific Island people in New Zealand.
SETTINGS
Eligible participants from Auckland City, New Zealand.
PARTICIPANTS
Individual face-to-face in-depth interviews were conducted with 36 older Pacific Island people who were experienced hearing difficulties.
METHODS
A Pacific Island research methodology () and the 'Health Care Access Barriers' (HCAB) model, which identifies modifiable barriers to healthcare, was used as a theoretical framework for this research. The interviews were transcribed and analysed using a deductive approach to identify HCAB themes and subthemes experienced by older Pacific Island people.
RESULTS
Identified themes aligned with HCAB's themes of financial, structural and cognitive barriers and subthemes described Pacific Island perspectives related to hearing care access in New Zealand. The financial barriers related to the high cost of hearing care and the structural barriers included transportation difficulties, limited family support, preference for community-based services and the absence of hearing care delivered by family doctors. Community norms and attitudes, communication limitations and limited awareness of hearing care services formed cognitive barriers among older Pasifika people in this study.
CONCLUSION
We identified financial, structural and cognitive barriers that dissuaded older Pasifika people from accessing hearing care services. These modifiable barriers need to be eliminated or minimised to enable people to readily receive the hearing care assistance they need. It is essential to improve and develop culturally responsive models of hearing service delivery to ensure equitable access to hearing care, especially for underserved groups such as Pacific Island communities.
目的
听力损失是影响老年人的最常见疾病之一。此外，人们对服务不足社区中影响听力服务获取的因素知之甚少。我们的目的是确定新西兰太平洋岛民老年人获得听力保健服务的障碍。
地点
新西兰奥克兰市符合条件的参与者。
参与者
对 36 名有听力困难的老年太平洋岛民进行了个体面对面深入访谈。
方法
采用太平洋岛民研究方法（）和“医疗保健获取障碍”（HCAB）模型，该模型确定了医疗保健的可改变障碍，作为本研究的理论框架。对访谈进行了转录和分析，采用演绎方法确定了老年太平洋岛民经历的 HCAB 主题和子主题。
结果
确定的主题与 HCAB 的财务、结构和认知障碍主题以及描述与新西兰听力保健获取相关的太平洋岛民观点的子主题一致。财务障碍与听力保健的高成本有关，结构障碍包括交通困难、家庭支持有限、对社区为基础的服务的偏好以及缺乏家庭医生提供的听力保健。社区规范和态度、沟通限制以及对听力保健服务的认识有限，是本研究中老年太平洋岛民的认知障碍。
结论
我们确定了阻止老年太平洋岛民获得听力保健服务的财务、结构和认知障碍。这些可改变的障碍需要消除或最小化，以使人们能够轻松获得所需的听力保健帮助。必须改善和发展对文化敏感的听力服务提供模式，以确保公平获得听力保健，特别是对服务不足的群体，如太平洋岛民社区。
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