Lategan Laetus, Van Zyl Gert, Kruger Willem
Central University of Technology, Bloemfontein.
Faculty of Health Sciences, University of the Free State, Bloemfontein.
J Public Health Afr. 2023 May 4;14(5):2252. doi: 10.4081/jphia.2023.2252. eCollection 2023 Apr 30.
Social determinants are defined as those nonmedical factors that influence health. Their influence is especially evident in vulnerable communities, such as the geriatric one. However, which social determinants will cause ethical challenges in geriatric healthcare in South Africa are not yet confirmed.
This study first identified which social determinants influence geriatric care. The study then established which of these social determinants raises ethical challenges in geriatric care.
Twenty statements were identified from the literature review and were grouped into 3 indexes, focusing respectively on i) a general view on public health and social determinants; ii) social determinants influencing geriatric people's health; iii) the consequences of social determinants on geriatric people's health. The rating was based on presenting the statements employing a 5- point Likert scale.
The rating of statements confirmed the generally accepted view that social determinants impact geriatric people's health. The responses to the statements were an additional confirmation that the quality and access to healthcare services influence geriatric care and lead to ethical challenges. Matters such as corruption, limited resources, and the COVID-19 pandemic contribute to the influence of social determinants and the expected but failed ethical behavior toward the geriatric community.
The geriatric community is vulnerable because of the ongoing social factors that have a negative impact on health, of which healthcare quality and provision are significant contributing factors. These factors contribute to ethical challenges in healthcare for the geriatric community.
社会决定因素被定义为那些影响健康的非医学因素。它们的影响在弱势群体社区,如老年人群体中尤为明显。然而,在南非老年医疗保健中,哪些社会决定因素会引发伦理挑战尚未得到证实。
本研究首先确定哪些社会决定因素影响老年护理。然后确定这些社会决定因素中的哪些会在老年护理中引发伦理挑战。
通过文献综述确定了20条陈述,并将其分为3个指标,分别关注:i)对公共卫生和社会决定因素的总体看法;ii)影响老年人健康的社会决定因素;iii)社会决定因素对老年人健康的影响。评分基于采用5点李克特量表呈现这些陈述。
陈述的评分证实了社会决定因素影响老年人健康这一普遍接受的观点。对这些陈述的回答进一步证实,医疗服务的质量和可及性影响老年护理并引发伦理挑战。诸如腐败、资源有限和新冠疫情等问题导致了社会决定因素的影响以及对老年群体预期但未实现的道德行为。
由于持续存在的对健康有负面影响的社会因素,老年群体较为脆弱,其中医疗质量和医疗服务提供是重要的促成因素。这些因素导致了老年群体医疗保健中的伦理挑战。