Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana
Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana
复制标题
DOI：
10.4102/ajod.v8i0.539
复制
发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Mji, Gubela
中科院分区：
文献类型：
--
作者：
Paulus-Mokgachane, Thato M.M.;Visagie, Surona J.;Mji, Gubela
背景：脊髓损伤（SCI）患者通常对医疗服务有很大的需求，但他们报告了获取挑战。初级保健访问SCI的人还没有被探索在Botswana.Objective：本研究旨在确定障碍和促进者，脊髓损伤的用户在访问初级保健服务的经验，在大哈博罗内地区，Botswana.Methods：进行了定量，横断面，观察性研究。数据收集与结构式问卷调查，从57名参与者与创伤性和非创伤性SCI。结果：男、女之比为2.8：1。参与者的平均年龄为40岁（标准差为9.59）。道路交通事故造成85%的伤害。大多数参与者在研究前的6个月内访问了2到10次初级保健机构。参与者对服务感到满意（63%），并认为设施干净（95%）和维护良好（73.5%）。优惠待遇、尊重、较短的等候时间和方便的时间促进了对服务的满意度。71.9%的参与者表示，供应商对SCI的知识不足，以及耗材短缺（80.7%）阻碍了供应。结构上的困难（42.1%的人不能自己进入设施，56.5%的人不能使用浴室）和缺乏高度可调的检查床（66.7%）阻碍了无障碍。当参与者（64.9%）利用私人医疗服务的公共服务未能满足他们的需求时，产生的成本。结论：初级保健服务大多是负担得起的，足够的。可得性、可接受性和可及性方面造成了障碍。
Background: People with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.Objective: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.Methods: A quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.Results: The male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.Conclusion: Primary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.