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社会决定因素对印度尼西亚人类免疫缺陷病毒护理质量的影响。

Social determinants of health on human immunodeficiency virus care quality in Indonesia.

机构信息

Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.

School of Nursing and Midwifery, Deakin University, Geelong, Australia.

出版信息

J Adv Nurs. 2023 May;79(5):1778-1788. doi: 10.1111/jan.15422. Epub 2022 Aug 20.

Abstract

AIMS

The aim was to examine the social determinants of health on human immunodeficiency virus care quality for children in Indonesia.

DESIGN

A qualitative design using constructivist grounded theory methods was utilized.

METHODS

Data were collected between 2019 and 2020 using in-depth- interviews and memo writing. In total, 23 semi-structured individual interviews with healthcare professionals, 12 with children with human immunodeficiency virus, and eight family members were conducted. Data were analysed with the two-step initial coding and focused coding, along with the constant comparative method, theoretical sensitivity and memo writing.

RESULTS

Five themes were constructed from participants' perspectives on human immunodeficiency virus care for children: (1) living with a low-socioeconomic status, (2) lacking instrumental support, (3) experiencing complicated procedures for public health insurance, (4) limited Human Immunodeficiency Virus care services for children and (5) lacking care coordination, policies and practices.

CONCLUSION

Children living with human immunodeficiency virus had poor health outcomes, due to having a low-socioeconomic status, reduced access to healthcare, coupled with a lack of social support services.

IMPACT

This study demonstrated how the social determinants of health negatively impact the quality of care for Indonesian children with human immunodeficiency virus and their families. Understanding these determinants would benefit health professionals, in particular nurses, to consider these factors in their assessment to create a holistic care plan for children living with human immunodeficiency virus and their families. Addressing the social determinants of health would beneficially enhance outcomes and well-being of children living with human immunodeficiency virus health in Indonesia.

摘要

目的

本研究旨在探讨印度尼西亚儿童艾滋病毒护理质量的健康社会决定因素。

设计

采用建构主义扎根理论方法的定性设计。

方法

2019 年至 2020 年期间,使用深入访谈和备忘录的方式收集数据。共进行了 23 次与医疗保健专业人员的半结构式个体访谈、12 次与艾滋病毒儿童的访谈以及 8 次与家庭成员的访谈。使用两步初始编码和聚焦编码、恒定性比较法、理论敏感性和备忘录写作来分析数据。

结果

从参与者对儿童艾滋病毒护理的角度构建了五个主题:(1)生活在低社会经济地位中,(2)缺乏工具性支持,(3)公共医疗保险程序复杂,(4)儿童艾滋病毒护理服务有限,(5)缺乏护理协调、政策和实践。

结论

由于社会经济地位低下,儿童获得医疗保健的机会减少,加上缺乏社会支持服务,因此,艾滋病毒患儿的健康结果不佳。

影响

本研究表明,健康的社会决定因素如何对印度尼西亚艾滋病毒患儿及其家庭的护理质量产生负面影响。了解这些决定因素将使卫生专业人员受益,特别是护士,他们在评估时应考虑这些因素,为艾滋病毒患儿及其家庭制定整体护理计划。解决健康的社会决定因素将有益于增强印度尼西亚艾滋病毒患儿的预后和幸福感。

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