A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.
A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.
复制标题
DOI：
10.1186/s12939-018-0753-9
复制
发表时间：
2018-04-03
影响因子：
4.8
通讯作者：
Fioratou E
中科院分区：
文献类型：
--
作者：
George S;Daniels K;Fioratou E
弱势少数群体，如欧洲罗姆人，在获得医疗服务方面往往面临重重障碍，导致健康状况恶化。这些障碍和结局均已在文献中广泛报道。然而，关于欧洲非罗姆土著社区面临的障碍的报告有限。“获得保健服务的障碍”模型确定了可以衡量和可能修改的有关财政、结构和认知障碍。因此，本研究的目的是探讨在罗马尼亚的慈善社区中心的家庭用户和工作人员认为，从一个混合种族的弱势群体获得医疗保健的障碍，并评估这些是否反映了从HCAB模型确定的障碍。11名社区成员的孩子参加了该中心和7名工作人员在该中心工作参加了面对面的半结构化访谈，探讨个人经验和对获得医疗保健的看法。采用初步演绎和二次归纳的方法对访谈进行了转录和分析，以确定HCAB的主题和其他新出现的主题和次主题。从这两个群体中确定的主题与HCAB的财务，结构和认知障碍和新兴的子主题的主题一致，重要的特定人群被确定。具体而言，财务障碍主要与医疗保险和贿赂问题有关，结构性障碍主要与服务的提供和获取有关，认知障碍主要与医疗保健专业人员的态度和歧视以及弱势群体缺乏教育和卫生知识有关。这两个群体都出现了一个独特的心理障碍主题，并伴随着这一弱势群体的不信任、绝望、恐惧和焦虑等副主题。目前的研究强调了在罗马尼亚参与慈善社区中心的弱势非罗姆人本地人口获得医疗保健的障碍。“弱势群体的医疗保健准入障碍”（HABVP）模型被提出作为对现有HCAB模型的适应，以解释这一人群独特的医疗保健感知障碍。提出了今后解决这些障碍的建议。本文的在线版本（10.1186/s12939-018-0753-9）包含补充材料，可供授权用户使用。
Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The “Health Care Access Barriers” (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre’s family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB’s themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals’ attitudes and discrimination and the vulnerable population’s lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a charity community centre in Romania. The “Healthcare Access Barriers for Vulnerable Populations” (HABVP) model is proposed as an adaption to the existing HCAB model to account for the unique perceived barriers to healthcare for this population. Recommendations for future resolution of these identified barriers are proposed. The online version of this article (10.1186/s12939-018-0753-9) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
4.4
作者：
Masseria, Cristina;Mladovsky, Philipa;Hernandez-Quevedo, Cristina
通讯作者：
Hernandez-Quevedo, Cristina
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM
影响因子：
1.7
作者：
Guest, Greg;Bunce, Arwen;Johnson, Laura
通讯作者：
Johnson, Laura
影响因子：
1.4
作者：
Carrillo, J. Emilio;Carrillo, Victor A.;Byron, Alex T.
通讯作者：
Byron, Alex T.
影响因子：
4.8
作者：
Hanssens, Lise G. M.;Devisch, Ignaas;Willems, Sara
通讯作者：
Willems, Sara