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改善贫民窟中老年居民的健康和社会保健服务:卫生专业人员的观点。

Improving health and social care services for slum-dwelling older adults: Perspectives of health professionals.

机构信息

School of Nursing and Midwifery, University of Ghana, Accra, Ghana.

Department of Health Services Research and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.

出版信息

Front Public Health. 2022 Oct 10;10:988076. doi: 10.3389/fpubh.2022.988076. eCollection 2022.

Abstract

BACKGROUND

Besides confronting the challenges of a growing older population, developing countries are dealing with limited resources and infrastructure, to ensure good health and social care services. One of these developing countries facing these challenges is Ghana. The healthcare system in Ghana currently does not have specialized geriatric services and is funded through the National Health Insurance Scheme (NHIS), private insurance companies and an out-of-pocket expenditure system. Social care services are important in improving Quality of Life (QoL) as it helps in building and strengthening relationships while also keeping slum-dwelling older adults active. There are various challenges with the health and social care of older adults in slums and practical ways to improve these have not been explored among the providers of this care.

AIMS

This study, therefore, aimed to explore (1) the views of health professionals on older slum-dwelling adults' health and social care needs, access, and use, and (2) recommendations for improving access to health and social care services among slum-dwelling older adults.

METHOD

A qualitative exploratory descriptive approach was used among health professionals by conducting a focus group discussion (FGD) and interviews. A semi-structured interview guide was used to collect data from each participant.

RESULTS

A total of 27 participants took part in the study. In the analysis of transcripts, 3 themes and 14 subthemes were conceptualized. Financial difficulties, queueing issues, distance to health facilities, health illiteracy and negative attitude of health professionals were identified as some barriers to the utilization of formal healthcare services. Social care services were described as non-existent, not structured, and having limited resources to cater for attendants. The health professionals also provided recommendations for improvement.

CONCLUSION

Health professionals in this study discussed barriers to access and use of health and social care services. Addressing these barriers is essential to improve the use of formal health and social care services and diminish health inequity among older adults.

摘要

背景

除了应对人口老龄化带来的挑战外,发展中国家还面临着资源和基础设施有限的问题,以确保提供良好的医疗保健和社会关怀服务。加纳就是这些面临这些挑战的发展中国家之一。加纳的医疗保健系统目前没有专门的老年服务,资金来源是国家健康保险计划(NHIS)、私人保险公司和自费支出系统。社会关怀服务对于提高生活质量(QoL)非常重要,因为它有助于建立和加强人际关系,同时让贫民窟的老年人保持活跃。贫民窟中老年人的医疗和社会关怀存在各种挑战,而这些服务提供者尚未探索出改善这些服务的实际方法。

目的

因此,本研究旨在探讨(1)卫生专业人员对贫民窟中老年居民的健康和社会关怀需求、获得途径和使用情况的看法,以及(2)改善贫民窟中老年居民获得卫生和社会关怀服务的建议。

方法

采用定性探索性描述方法,对卫生专业人员进行焦点小组讨论(FGD)和访谈。使用半结构式访谈指南从每位参与者处收集数据。

结果

共有 27 名参与者参与了这项研究。在对转录本的分析中,确定了 3 个主题和 14 个子主题。经济困难、排队问题、距离医疗设施的远近、健康知识匮乏和卫生专业人员的消极态度被认为是利用正规医疗保健服务的一些障碍。社会关怀服务被描述为不存在、不规范且资源有限,无法满足照顾者的需求。卫生专业人员还提出了改进建议。

结论

本研究中的卫生专业人员讨论了获取和使用卫生和社会关怀服务的障碍。解决这些障碍对于改善正规卫生和社会关怀服务的利用以及减少老年人中的健康不平等至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1a/9589493/c28cba954ed7/fpubh-10-988076-g0001.jpg

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