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Effects of COVID-19 Among People With Disabilities in Plumtree, Zimbabwe: A Mixed-Method Survey. COVID-19 在津巴布韦普拉姆特里残疾人中的影响:混合方法调查。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241274484
Lindiwe Ndlovu, Nicholas Mudonhi, Nomathemba Sibanda, Wilfred Njabulo Nunu, Norman Manyeruke

Introduction: Persons with disabilities are the most affected by rising pandemics worldwide. COVID-19 has affected people with disabilities in many areas of their lives; however, its impact has been overlooked. This study aimed to assess the effects of COVID-19 on people with disabilities in Plumtree, Zimbabwe, to develop a disability-inclusive approach in response to COVID-19.

Methods: A concurrent mixed-methods approach was used to collect qualitative and quantitative data from 7 key informants and ninety-two participants with disabilities, from January to May 2023. Quantitative data were analysed using STATA software version 12 and Microsoft Excel. Multiple Logistic Regression, Chi-square test, and paired-sample test were used to test for associations among COVID-19 cases, source of income, key challenges, and demographic characteristics. Qualitative data were analysed and presented in the form of themes.

Results: We recruited more females (56.5%) than males with disabilities, and more than half were unemployed (56.5%). In contrast, only 3.3% of the respondents were formally employed. The results also indicated a significant relationship between age and COVID-19 positivity (P = .025). The results also indicated that efforts were being made by government and non-governmental departments to assist people with disabilities during the pandemic through finance, food, awareness campaigns, and social support.

Conclusion: Restriction measures put in place disturbed the livelihood of people with disabilities in Plumtree. Therefore, entrepreneurship programmes targeting vulnerable groups, including people with disabilities, should be introduced to ensure that their sources of income are sustained despite emergencies or pandemics.

导言:残疾人是全球受流行病影响最大的群体。COVID-19 对残疾人生活的许多方面都产生了影响,但其影响却一直被忽视。本研究旨在评估 COVID-19 对津巴布韦普拉姆特里镇残疾人的影响,从而制定出一种兼顾残疾人的方法来应对 COVID-19:在 2023 年 1 月至 5 月期间,采用混合方法从 7 名关键信息提供者和 92 名残疾人参与者处收集定性和定量数据。定量数据使用 STATA 软件第 12 版和 Microsoft Excel 进行分析。使用多元 Logistic 回归、卡方检验和配对样本检验来检验 COVID-19 病例、收入来源、主要挑战和人口特征之间的关联。对定性数据进行了分析,并以主题的形式呈现:我们招募的残疾女性(56.5%)多于残疾男性,一半以上为失业者(56.5%)。相比之下,只有 3.3% 的受访者有正式工作。结果还表明,年龄与 COVID-19 阳性率之间存在显著关系(P = .025)。结果还表明,在大流行期间,政府和非政府部门正在努力通过财政、食品、宣传活动和社会支持等方式帮助残疾人:结论:所采取的限制措施扰乱了梅树镇残疾人的生活。因此,应引入针对弱势群体(包括残疾人)的创业计划,以确保他们的收入来源能够在紧急情况或流行病发生时得以维持。
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引用次数: 0
The Influence of Institutional Logics and Emotions on the Uptake of Cervical Cancer Screening: A Case Study From Xai-Xai, Mozambique. 制度逻辑和情感对接受宫颈癌筛查的影响:莫桑比克 Xai-Xai 案例研究》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.1177/11786329231224619
Gefra Fulane, Maria Major, Cesaltina Lorenzoni, Khatia Munguambe

This study investigates the role of emotional attachment to competing institutional logics on women's uptake of cervical cancer screening in Mozambique. Through a qualitative study conducted in Xai-Xai, Southern Mozambique, we identify 2 concurrent logics in the context of screening: preservation logic, influenced by social-cultural norms, and the prevention logic, centered around screening. Women, affected by emotions such as shame, fear, and marital subordination, often become attached to the preservation logic, which influences their values and contradicts acceptance of screening. However, some women with marital autonomy may reflect on both logics and gradually detach themselves from the preservation norms and show their intention to adopt life-saving behavior by accepting screening. It is through their emotions that women show their attachment to and detachment from competing logics, reinforcing traditional norms on the one hand, or giving them the means to adopt preventive measures on the other. The study indicates that cultural expectations, shame and the desire to preserve intimacy tie women to the logic of preservation and have a negative impact on participation in cervical cancer screening. Consequently, to improve screening uptake in Mozambique, the authorities need to adapt screening to socio-cultural and emotional factors, empower women, and effectively engage communities.

本研究调查了莫桑比克妇女在接受宫颈癌筛查时对相互竞争的制度逻辑所产生的情感依恋。通过在莫桑比克南部赛赛(Xai-Xai)进行的一项定性研究,我们确定了筛查背景下的两种并存逻辑:受社会文化规范影响的保护逻辑和以筛查为中心的预防逻辑。妇女受到羞耻、恐惧和婚姻从属地位等情绪的影响,往往会依附于保护逻辑,这影响了她们的价值观,并与接受筛查相矛盾。然而,一些拥有婚姻自主权的妇女可能会对这两种逻辑进行反思,逐渐从保护规范中脱离出来,并通过接受筛查来表明自己采取挽救生命行为的意愿。妇女正是通过她们的情感表现出她们对相互竞争的逻辑的依恋和疏离,这些逻辑一方面强化了传统规范,另一方面也给了她们采取预防措施的手段。研究表明,文化期望、羞耻感和保持亲密关系的愿望将妇女束缚在保持亲密关系的逻辑中,对参与宫颈癌筛查产生了负面影响。因此,为了提高莫桑比克的筛查率,当局需要使筛查适应社会文化和情感因素,增强妇女的能力,并有效地让社区参与进来。
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引用次数: 0
Modelling the Wage Bill and Budget Space for Health Workforce in Ghana: Implications for Sustainable Health Professions Education Policy. 加纳卫生劳动力的工资法案和预算空间建模:对可持续卫生专业教育政策的影响》(Modelling the Wage Bill and Budget Space for Health Workforce in Ghana: Implications for Sustainable Health Professions Education Policy)。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-18 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241271568
Hamza Ismaila, Juliet Nabyonga-Orem, Yolande Heymans, Christmal Dela Christmals

Global discussions on health systems strengthening have lately tilted towards increasing investments in human resources for health to address health workforce challenges, especially shortages and employment. Countries have, as a result, increased investments in the health workforce by expanding the production and recruitment of the needed health workforce, with the resultant effects of increasing health workforce budget space and the unending clamour by health policy actors for further increases. Despite these calls, there has been no wage bill affordability and budget space analysis to rationalise the sustainable production of and demand for health workers, which is the thrust of Ghana's current health workforce policy and strategy. Using an adapted approach (the Asamani approach), the study modelled the supply of some essential health workers and their associated cost of employment, compared it with the modelled budget space for health workforce employment and then drew conclusions on the wage bill sustainability for policy consideration. Of the seven cadres considered in the study (doctors, professional nurses, midwives, enrolled nurses, community health nurses, pharmacists and biomedical scientists), who constitute about 97% of the wage bill, the study found the baseline stock to be 129 378 in 2022, which was estimated to increase to 199 715 by 2027 and 254 466 by 2032 with corresponding wage bills of US$869.4 million and US$ 1.1 billion, respectively, holding routine salary increases constant. The budget space for health was, meanwhile, projected to be US$899.3 million and US$1.1 billion in 2022 and 2032 respectively, out of a projected overall government fiscal space of US$7 billion per year. This study concludes that, given current levels and mix of production, Ghana was estimated to expend an average of 88% of its health budget space as wage bill cost. This was 54.4% over the global median and 95.6% over the African Region's median, making the current regime unsustainable.

最近,全球关于加强卫生系统的讨论倾向于增加对卫生人力资源的投资,以 应对卫生工作人员的挑战,特别是短缺和就业问题。因此,各国增加了对卫生人员队伍的投资,扩大了所需卫生人员队伍的生产和招聘,其结果是增加了卫生人员队伍的预算空间,卫生政策参与者也不断呼吁进一步增加预算。尽管有这些呼声,但一直没有对工资总额的承受能力和预算空间进行分析,以合理确定卫生工作人员的可持续生产和需求,而这正是加纳当前卫生工作人员政策和战略的主旨。这项研究采用了一种经过调整的方法(阿萨马尼方法),对一些基本卫生工作者的供应及其相关就业成本进行建模,将其与建模的卫生工作者就业预算空间进行比较,然后得出关于工资总额可持续性的结论,供政策考虑。在研究中考虑的七种干部(医生、专业护士、助产士、注册护士、社区保健护士、药剂师和生物医 学科学家)中,他们约占工资总额的 97%,研究发现 2022 年的基线存量为 129378 人,估计到 2027 年将增加到 199715 人,到 2032 年将增加到 254 466 人,在常规工资增长不变的情况下,相应的工资总额分别为 8.694 亿美元和 11 亿美元。与此同时,在政府每年预计 70 亿美元的总体财政空间中,预计 2022 年和 2032 年的卫生预算空间分别为 8.993 亿美元和 11 亿美元。本研究的结论是,考虑到目前的生产水平和生产组合,估计加纳平均 88% 的卫生预算空间将用于支付工资支出。这比全球的中位数高出 54.4%,比非洲地区的中位数高出 95.6%,使现行制度难以为继。
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引用次数: 0
Assessing the Carbon Footprint of Telemedicine: A Systematic Review. 评估远程医疗的碳足迹:系统回顾。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-11 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241271562
Casper van der Zee, Jennifer Chang-Wolf, Marc A Koopmanschap, Redmer van Leeuwen, Robert Pl Wisse

Background: Healthcare is responsible for 4% to 10% of carbon emissions worldwide, of which 22% is related to transport. Telemedicine emerged as a potential solution to reduce the footprint, for example, by reducing travel. However, a need to understand which variables to include in carbon footprint estimations in telemedicine limits our understanding of the beneficial impact telemedicine might have on our environment. This paper aims to systematically assess the reported carbon footprint and include variables assessed by the literature, comparing telemedicine with usual care.

Methods: The systematic review followed the PRISMA guidelines in PubMed, Medline, Embase and Scopus. A quality assessment was performed using a transparency checklist for carbon footprint calculators. Carbon emissions were evaluated based on four categories, including patient travel, and streamlined life cycle assessment (LCA) for assessing included variables relevant to telemedicine.

Results: We included 33 articles from 1117 records for analysis. The average transparency score was 38% (range 18%-68%). The median roundtrip travel distance for each patient was 131 km (interquartile range [IQR]: 60.8-351), or 25.6 kgCO2 (IQR: 10.6-105.6) emissions. There is high variance among included variables. Saved emissions are structurally underestimated by not including external factors such as a streamlined LCA.

Conclusions: Telemedicine aids in reducing emissions, with travel distance being the most significant contributor. Additionally, we recommend accounting for the LCA since it highlights important nuances. This review furthers the debate on assessing carbon footprint savings due to telemedicine.

背景:医疗保健占全球碳排放量的 4%至 10%,其中 22%与交通有关。远程医疗是减少碳足迹的潜在解决方案,例如通过减少旅行。然而,需要了解哪些变量应纳入远程医疗碳足迹估算,这限制了我们对远程医疗可能对环境产生的有益影响的理解。本文旨在系统地评估所报告的碳足迹,并纳入文献所评估的变量,对远程医疗与常规护理进行比较:方法:在 PubMed、Medline、Embase 和 Scopus 上进行的系统性综述遵循了 PRISMA 指南。采用碳足迹计算器透明度检查表进行了质量评估。碳排放量根据四个类别进行评估,包括患者旅行和简化生命周期评估(LCA),以评估与远程医疗相关的变量:我们从 1117 条记录中选取了 33 篇文章进行分析。平均透明度得分为 38%(范围为 18%-68%)。每位患者的往返距离中位数为 131 千米(四分位数间距 [IQR]:60.8-351),或 25.6 千克 CO2(四分位数间距 [IQR]:10.6-105.6)排放量。各变量之间存在很大差异。由于不包括简化生命周期评估等外部因素,节省的排放量被结构性低估:结论:远程医疗有助于减少排放,而旅行距离是最重要的因素。此外,我们建议考虑生命周期评估,因为它能突出重要的细微差别。这篇综述进一步推动了关于评估远程医疗所带来的碳足迹减少的讨论。
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引用次数: 0
A Lack of Tourism-Based Health Services Amid Global Aging: How Tourism and Health Practices Can Combine to Benefit the Aging Population. 全球老龄化进程中缺乏基于旅游的健康服务:旅游与健康实践如何结合,造福老龄人口。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-09 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241271570
Jun Wen
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引用次数: 0
The Medical Complexity of Newly Admitted Long-Term Care Residents Before and During the COVID-19 Pandemic in Ontario, British Columbia, and Alberta: A Serial Cross-Sectional Study. 安大略省、不列颠哥伦比亚省和艾伯塔省 COVID-19 大流行之前和期间新入住的长期护理居民的医疗复杂性:连续横断面研究
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-03 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241266675
Razan Al-Sharkawi, Luke A Turcotte, John P Hirdes, George Heckman, Caitlin McArthur

The COVID-19 pandemic had profound effects on the long-term care (LTC) setting worldwide, including changes in admission practices. We aimed to describe the characteristics and medical complexity of newly admitted LTC residents before (March 1, 2019 to February 29, 2020) and during (March 1, 2020 to March 31, 2021) the COVID-19 pandemic via a population-based serial cross-sectional study in Ontario, Alberta, and British Columbia, Canada. With data from the Minimum Data Set 2.0 we characterize the medical complexity of newly admitted LTC residents via the Geriatric 5Ms framework (mind, mobility, medication, multicomplexity, matters most) through descriptive statistics (counts, percentages), stratified by pandemic wave, month, and province. We included 45 756 residents admitted in the year prior to and 35 744 during the first year of the pandemic. We found an increased proportion of residents with depression, requiring extensive assistance with activities of daily living, hip fractures, antipsychotic use, expected to live <6 months, with pneumonia, low social engagement, and admitted from acute care. Our study confirms an increase in medical complexity of residents admitted to LTC during the pandemic and can be used to plan services and interventions and as a baseline for continued monitoring in changes in population characteristics over time.

COVID-19 大流行对全球的长期护理(LTC)环境产生了深远影响,包括入院方式的改变。我们旨在通过在加拿大安大略省、艾伯塔省和不列颠哥伦比亚省开展的一项基于人群的序列横断面研究,描述 COVID-19 大流行之前(2019 年 3 月 1 日至 2020 年 2 月 29 日)和期间(2020 年 3 月 1 日至 2021 年 3 月 31 日)新入院的长期护理住院患者的特征和医疗复杂性。我们利用最小数据集 2.0 中的数据,通过描述性统计(计数、百分比),并按大流行浪潮、月份和省份分层,采用老年医学 5Ms 框架(精神、行动、用药、多重复杂性、最重要)描述了新入院的 LTC 居民的医疗复杂性。我们纳入了大流行前一年收治的 45 756 名住院患者和大流行第一年收治的 35 744 名住院患者。我们发现,患有抑郁症、日常生活活动需要大量协助、髋部骨折、使用抗精神病药物、预期寿命较短的住院患者比例有所增加。
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引用次数: 0
The Capacitated Maximal Covering Location Problem Improves Access to Stroke Treatment: A Cross-Sectional Simulation Study. 有能力的最大覆盖位置问题改善了脑卒中治疗的可及性:横断面模拟研究》。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241263699
Kyohei Bando, Kazuki Ohashi, Kensuke Fujiwara, Toshiya Osanai, Yasuhiro Morii, Takumi Tanikawa, Miki Fujimura, Katsuhiko Ogasawara

Disparities in accessing advanced stroke treatment have been recognized as a policy challenge in multiple countries, including Japan, necessitating priority solutions. Nevertheless, more practical healthcare policies must be implemented due to the limited availability of healthcare staff and financial resources in most nations. This study aimed to evaluate the supply and demand balance of mechanical thrombectomy (MT) and identify areas with high priority for enhancing stroke centers. The target area of this study was Hokkaido, Japan. We adopted the capacitated maximal covering location problem (CMCLP) to propose an optimal allocation without increasing the number of medical facilities. Four realistic scenarios with varying levels of total MT supply capacity for Primary stroke centers and assuming a range of 90 minutes by car from the center were created and simulated. From scenarios 1 to 4, the coverage increased by approximately 53% to 85%, scenarios 2 and 3 had 5% oversupply, and scenario 4 had an oversupply of approximately 20%. When the supply capacity cap was eliminated and 8 PSCs received 31 or more patients, they became priority enhancement targets. The CMCLP estimates demand coverage considering the supply and demand balance and indicates areas and facilities where MT supply capacity enhancement is a priority.

在包括日本在内的多个国家,获得高级卒中治疗方面的差异已被视为一项政策挑战,需要优先解决。然而,由于大多数国家的医护人员和财政资源有限,因此必须实施更加切实可行的医疗政策。本研究旨在评估机械取栓术(MT)的供需平衡情况,并确定需要优先加强卒中中心的地区。本研究的目标地区是日本北海道。我们采用了容纳最大覆盖位置问题(CMCLP),在不增加医疗设施数量的情况下提出了最佳分配方案。我们创建并模拟了初级卒中中心总 MT 供应能力水平不同的四种实际情况,并假定距离中心 90 分钟车程的范围。从方案 1 到方案 4,覆盖率增加了约 53% 到 85%,方案 2 和方案 3 出现了 5% 的供过于求,方案 4 出现了约 20% 的供过于求。当供应能力上限被取消,8 个初级保健中心接收了 31 名或更多的病人时,这些中心就成了优先加强的目标。考虑到供需平衡,CMCLP 估算了需求覆盖范围,并指出了优先提高 MT 供应能力的地区和设施。
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引用次数: 0
Barriers and Facilitators to Dietary Salt Reduction Among Patients With Hypertension in Southern Nigeria: A Hospital-based Qualitative Study. 尼日利亚南部高血压患者膳食减盐的障碍和促进因素:一项基于医院的定性研究。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-27 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241266674
Afiong Oboko Oku, Ndifreke Ekpo Udonwa, Tijani Idris Ahmad Oseni, Temitope Ilori, Tawakalit Olubukola Salam

Introduction: Reduction in salt intake improves blood pressure control and reduces the risk of hypertension and other noncommunicable diseases (NCDs). However, salt intake remains high among Nigerians. This study aimed to identify barriers and facilitators to salt reduction among hypertensive patients attending a family medicine clinic in southern Nigeria.

Methodology: A focussed group discussion (FGD) exploring patients' perceptions of the barriers and facilitators to salt reduction was conducted with 8 groups of purposefully selected 74 hypertensives who consumed excess dietary salt, stratified by age and sex, using an FGD guide. Thematic analysis was then performed using Nvivo® version 12 pro. Ethical approval was obtained from Irrua Specialist Teaching Hospital (ISTH), and written informed consent was obtained from the patients before the FGD.

Results: Respondents had a mean age of 51.96 ± 8.98 years. The majority were females (47, 63.5%) and had uncontrolled blood pressure (66, 89.2%). Five major themes were identified, from which several minor themes emerged. Respondents rated their overall health as good but expressed concerns about their poor blood pressure control. Identified barriers to salt reduction included family pressure, ignorance, ready availability and affordability of salt and lack of affordable alternatives. Facilitators of salt reduction were measuring the amount of cooking salt, removing salt from the dining table and providing substitutes. Respondents, however, expressed willingness to reduce their salt consumption.

Conclusion: The study identified barriers and facilitators to salt reduction. There is a need to create awareness of the safe amount of salt to be consumed and provide safe and readily available alternatives.

导言:减少食盐摄入量可改善血压控制,降低罹患高血压和其他非传染性疾病(NCD)的风险。然而,尼日利亚人的食盐摄入量仍然很高。本研究旨在确定在尼日利亚南部一家家庭医疗诊所就诊的高血压患者减少食盐摄入量的障碍和促进因素:使用 FGD 指南,对特意挑选的 74 名膳食盐摄入过量的高血压患者分年龄和性别进行了 8 组分组讨论,探讨患者对减盐障碍和促进因素的看法。然后使用 Nvivo® 12 专业版进行了专题分析。FGD获得了Irrua专科教学医院(ISTH)的伦理批准,并在FGD前获得了患者的书面知情同意:受访者的平均年龄为 51.96 ± 8.98 岁。大多数受访者为女性(47 人,占 63.5%),血压未得到控制(66 人,占 89.2%)。共确定了五大主题,并从中产生了几个次要主题。受访者认为自己的总体健康状况良好,但对血压控制不佳表示担忧。已确定的减盐障碍包括家庭压力、无知、盐的随时供应和可负担性以及缺乏可负担的替代品。促进减盐的因素包括测量烹饪用盐量、从餐桌上移除食盐以及提供替代品。不过,受访者表示愿意减少食盐摄入量:研究发现了减盐的障碍和促进因素。有必要提高人们对食盐安全摄入量的认识,并提供安全易得的替代品。
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引用次数: 0
The Effect of Economic Growth on the Utilisation of Childhood Immunisation: New Evidence From 50 African Countries. 经济增长对儿童免疫接种利用率的影响:来自 50 个非洲国家的新证据
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-24 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241261990
Mustapha Immurana, Abdul Mumin Abdul Rahman

Africa bears the greatest brunt of under-five mortality in the world. Among the major approaches used in tackling under-five deaths is childhood immunisation. While income is regarded as a major determinant of demand for child health inputs including immunisation, the existing studies are microlevel analyses, which do not provide a bigger picture of how an enhancement in economic growth (aggregate income) contributes to the utilisation of childhood immunisation in an economy as a whole. Since Africa has experienced economic growth in the recent decades, this study aims to fill this gap in the literature by examining the contribution of economic growth to the utilisation of childhood immunisation in selected African countries. The study uses a panel design involving data on 50 African countries over the period, 2002 to 2019. Utilisation of DPT (diphtheria, pertussis (or whooping cough) and tetanus) and measles immunisation are used as proxies for childhood immunisation while the system Generalised Method of Moments (GMM) regression is used as the estimation technique. We find economic growth to have a positive significant effect on the utilisation of childhood immunisation. Thus, it is imperative to intensify the enablers of economic growth in Africa in order to increase the utilisation of childhood immunisation.

非洲是世界上五岁以下儿童死亡率最高的地区。解决五岁以下儿童死亡问题的主要方法之一是儿童免疫接种。虽然收入被认为是包括免疫接种在内的儿童健康投入需求的主要决定因素,但现有的研究都是微观层面的分析,无法从整体上说明经济增长(总收入)的提高如何促进儿童免疫接种在整个经济体中的利用。由于非洲近几十年来经历了经济增长,本研究旨在通过研究经济增长对部分非洲国家儿童免疫接种利用率的贡献,填补文献中的这一空白。本研究采用面板设计,涉及 2002 年至 2019 年期间 50 个非洲国家的数据。白喉、百日咳(或百日咳)和破伤风三联疫苗(DPT)和麻疹免疫接种的利用率被用作儿童免疫接种的替代指标,而系统广义矩法(GMM)回归被用作估计技术。我们发现,经济增长对儿童免疫接种的利用率有积极的显著影响。因此,必须加强非洲经济增长的推动因素,以提高儿童免疫接种的利用率。
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引用次数: 0
Person-Centered Coordinated Care Experience of People With Long-Term Conditions in the Balearic Islands Measured by the P3CEQ. 通过 P3CEQ 测量巴利阿里群岛长期病患者以人为本的协调护理体验。
IF 2.8 Q2 Medicine Pub Date : 2024-06-13 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241258856
Gabriel Mercadal-Orfila, Salvador Herrera-Pérez, Núria Piqué, Francesc Mateu-Amengual, Pedro Ventayol-Bosch, Maria Antonia Maestre-Fullana, Joaquin Ignacio Serrano-López de Las Hazas, Francisco Fernández-Cortés, Francesc Barceló-Sansó, Santiago Rios

Objective: This study aimed to use the Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) to assess the experience of person-centered coordinated care among people with long-term conditions in the Balearic Islands, Spain.

Methods: Over 1300 participants receiving treatment for chronic conditions or HIV pre-exposure prophylaxis were invited to complete the P3CEQ and a socio-demographic questionnaire, both administered electronically via the Naveta app. The P3CEQ assesses the key domains of the P3C through an 11-item questionnaire. Items 1, 2, 3, 4, 5, 8, 9 and 10 assess specifically person-centredness (PC subscale), while items 5, 6, 7, 8 and 9 measure care coordination (CC subscale; question 7 includes 4 sub-questions to specifically assess care plans). Descriptive statistics were used to summarize patient characteristics and P3CEQ items scores. Data analysis included chi-squared test of independence, Student's t-test and analysis of variance test. Pairwise comparisons were adjusted by Bonferroni correction.

Results: The P3CEQ and a socio-demographic questionnaire were sent to 1313 individuals (651 men, 657 women, 5 'other gender'). A response rate of 35.34% was achieved, with 464 P3CEQ responders (223 men and 241 women). Significant differences in response rates were observed by age, smoking status, alcohol consumption, membership of patient organizations, and use of alternative medicine. Care planning was rated significantly lower than other measured domains. Women experienced less person-centered care than men (16.64 vs 17.91) and rated care coordination worse than their male counterparts (9.18 vs 10.23). There were also differences in scores between medical condition types, with cancer and inflammatory bowel disease patients rating highest for both person-centered care (21.20 and 19.13, respectively) and care coordination (10.70 vs 10.88, respectively). Patients with skin and rheumatic diseases rated lowest their experience of person-centered care. People with higher education and those employed or studying experienced better person-centeredness.

Conclusion: Using the P3CEQ, we detected significant differences in the care experiences of people with chronic conditions, suggesting the need to address potential gender biases, social inequalities, and the poorer ratings observed for certain conditions in the study population.

研究目的本研究旨在使用 "以人为本的协调护理体验问卷"(P3CEQ)来评估西班牙巴利阿里群岛长期病患者对 "以人为本的协调护理 "的体验:我们邀请了 1300 多名接受慢性病治疗或艾滋病暴露前预防治疗的患者填写 P3CEQ 问卷和社会人口调查问卷,这两份问卷均通过 Naveta 应用程序以电子方式发放。P3CEQ 通过一份 11 个项目的问卷来评估 P3C 的关键领域。项目 1、2、3、4、5、8、9 和 10 专门评估以人为本(PC 子量表),而项目 5、6、7、8 和 9 则测量护理协调(CC 子量表;问题 7 包括 4 个子问题,专门评估护理计划)。描述性统计用于总结患者特征和 P3CEQ 项目得分。数据分析包括独立性卡方检验、学生 t 检验和方差分析检验。配对比较采用 Bonferroni 校正:共向 1313 人(651 名男性、657 名女性和 5 名 "其他性别")发送了 P3CEQ 和社会人口调查问卷。回复率为 35.34%,其中 464 人回复了 P3CEQ(223 名男性和 241 名女性)。不同年龄、吸烟状况、饮酒量、患者组织成员以及替代医学的使用情况在回复率上存在显著差异。护理规划的评分明显低于其他测量领域。女性体验到的以人为本的护理比男性少(16.64 分对 17.91 分),对护理协调的评价也比男性差(9.18 分对 10.23 分)。不同病症类型之间的得分也存在差异,癌症和炎症性肠病患者在以人为本的护理(分别为 21.20 分和 19.13 分)和护理协调(分别为 10.70 分和 10.88 分)方面的评分最高。皮肤病和风湿病患者对 "以人为本 "护理的评价最低。受过高等教育、有工作或正在学习的人对以人为本的体验更好:通过使用 P3CEQ,我们发现慢性病患者的护理体验存在显著差异,这表明有必要解决潜在的性别偏见、社会不平等以及研究人群中某些病症的评分较低等问题。
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Health Services Insights
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