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PubMed2001

I want to know: exploring how older women acquire health knowledge after a myocardial infarction.

The purpose of this descriptive naturalistic study was to: (a) explore how older women not participating in outpatient cardiac rehabilitation (CR) acquire health knowledge regarding secondary prevention measures after a myocardial infarction (MI), and (b) describe women's perceived barriers to acquiring this knowledge. Women (N = 15), ages 66-88, participated in semi-structured in-depth interviews. Data analysis resulted in four global categories: (a) previous learning, (b) self knowledge, (c) actively seeking knowledge from others, and (d) information provided by others. Barriers to acquiring health knowledge after MI without the support of outpatient CR were also identified.

Aged↗
PubMed1999

Exploring lay definitions of asthma and interpersonal barriers to care in a predominantly Puerto Rican, inner-city community.

Lay definitions of asthma were elicited through a single open-ended question from a population-based sample of mostly Puerto Rican, inner-city residents in Buffalo, New York. One hundred fifty-five household responses to the question, "What do you think asthma is?" were analyzed qualitatively using the editing approach. Five common codes emerged in order of significance: "symptoms," "disease," "triggers," "threat," and "coping." Overall, expressions of illness reflected a largely symptomatic perception of asthma regardless of asthma status. Perceptions of "disease" increased with higher level of education. Patients' definitions of illness should be considered to help reduce interpersonal barriers to asthma care.

Adaptation, Psychological↗
PubMed2000

Differences in AIDS knowledge among Spanish and English speakers by socioeconomic status and ability to speak English.

Previous studies have shown that Hispanics know less about acquired immunodeficiency syndrome (AIDS) than non-Hispanics, but few studies have examined the role of language or socioeconomic status. We used data from a 1998 population-based sample survey of New Jersey adults to compare levels of AIDS knowledge among English and Spanish speakers, taking into account educational attainment and ability to speak English. Spanish speakers, especially those who filled out the questionnaire in Spanish, knew less about AIDS transmission, although their general AIDS knowledge was comparable to English speakers with similar educational attainment. Differences between Hispanics who speak primarily English and those who speak primarily Spanish underscore the idea that linguistic and cultural barriers vary within a cultural group and should be taken into account in the design of AIDS education programs.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families.

This study examined the role of parent psychopathology and quality of life in predicting barriers to participation in outpatient treatment and therapeutic change among clinically referred children. Children (N = 169) referred for oppositional, aggressive, and antisocial behavior and their families participated. The major findings were that (1) higher levels of parent psychopathology and lower levels of quality of life predicted the subsequent emergence of perceived barriers to treatment in the parents and therapeutic changes among the children, (2) these effects were not explained by socioeconomic disadvantage or severity of child dysfunction, (3) perceived barriers and therapeutic changes were related and this relation was not explained by other family and child predictors, (4) as the level of perceived barriers increased among families, the amount of therapeutic change and the proportion of children who made a marked change decreased, and (5) parent perception of the relevance and demandingness of treatment were salient dimensions contributing to the relation between perceived barriers and therapeutic change. The conceptual and applied implications of relating barriers to treatment and therapeutic change are discussed.

Adolescent↗
PubMed2002

Health care utilization and adults who are deaf: relationship with age at onset of deafness.

OBJECTIVES: To evaluate the health care utilization of a nationally representative sample of U.S. deaf adults while accounting for the age at onset of deafness, an indicator of linguistic and sociocultural group affiliation. DATA SOURCES/STUDY SETTING: Data from the 1990 to 1991 National Health Interview Surveys the most recent years the Hearing Supplement was administered. The data were collected during in-home interviews of a sample of the U.S. civilian noninstitutionalized population. STUDY DESIGN: Cross-sectional analyses comparing health-related measures of adults deafened before (prelingually) and after (postlingually) the age of 3 and those of a representative sample of the general population, adjusting for sociodemographics and health status. Key measures were physician visits and preventive health care services utilization. PRINCIPAL FINDINGS: Compared with the general population, prelingually deafened adults had fewer physician visits and were less likely to have visited a physician in the preceding 2 years, whereas postlingually deafened adults had more physician visits and were more likely to have visited a physician in the preceding 2 years. Postlingually deafened women were less likely to have had a mammogram within the previous 2 years. CONCLUSIONS: In terms of health care utilization, the deaf population is heterogeneous. Prelingually deafened adults' use of health care is similar to that of other language minority groups. Postlingually deafened adults' use of health care services appears similar to people with chronic illness. Future studies must distinguish different groups of people with hearing loss in order to identify barriers and monitor improvements in health care services access.

Adolescent↗
PubMed1993

Lay health beliefs concerning HIV and AIDS--a barrier for control programmes.

Work in AIDS control in East Africa revealed widespread lay health beliefs concerning HIV infection and AIDS amongst health workers and members of the general population at both lower and higher risk of infection. The beliefs were often factually incorrect and undermining to AIDS control in the field of information, education and communication (IEC). The beliefs were conveyed informally but their origins could often be traced. Local media were important sources. The beliefs were powerful, persistent and resistant to conventional educational methods. Their prevalence and type changed with time in different groups. A model of how the beliefs came to be generated is proposed and reasons suggested for their persistence and strength. A current programme for countering the beliefs is described. An additional important group of policy and scientific beliefs were also identified amongst policy makers and scientists. It is noted that these phenomenon are international and not confined to Africa.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The power of mediation.

There is a range of intervention strategies and procedures designed to assist parties in reaching agreement, from negotiation, over which parties have complete control, to arbitration, the process over which they have the least control. In the middle of this spectrum is mediation. Simply put, mediation is assisted negotiation. A mediator is an impartial person (or team) that works with the parties, mostly together and sometimes separately, to help them reach an agreement to resolve a dispute. The cornerstones of mediation are impartiality and confidentiality. The logic of mediation is that disputants can easily fall into many pitfalls trying to resolve a dispute without help. This article explores these common barriers to effective direct negotiations--such as overestimating the likelihood of prevailing through power, litigation, or arbitration--and presents a case study describing how a complex set of problems was resolved through mediation.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Diagramming patients' views of root causes of adverse drug events in ambulatory care: an online tool for planning education and research.

OBJECTIVE: Diagram patients' views of the causes of adverse drug events (ADEs) in ambulatory care, examine characteristics of causes reported by patients, and identify those that have been studied in the medical and social science literatures. METHODS: Twenty-two primary care patients were interviewed using a root cause analysis approach. Diagrams derived from interviews were consolidated and displayed online as a composite interactive causal diagram. Patient-reported causes were compared to evidence in the social science and medical literatures. RESULTS: Patients ascribed 164 causes to ADEs occurring through eight major pathways, including medication nonadherence, prescriber-patient miscommunication, patient medication error, failure to read medication label/insert, polypharmacy, patient characteristics, pharmacist-patient miscommunication, and self medication. Most frequently reported causes were intrapsychic and interpersonal in nature. Most patient-reported causes have been studied, however, several practical and motivational antecedents lack research. CONCLUSION: Conducting root cause analysis with patients reveals multiple logically linked aspects of medication safety in community settings that merit further research and consideration in patient and prescriber education. PRACTICE IMPLICATIONS: This causal diagram provides a broadly accessible planning tool for reducing ambulatory ADEs by showing a comprehensive picture of potential causes, identifying causal factors supported by evidence, and disclosing likely consequences of change efforts. Also, patient-centered medication safety strategies should address psychological and practical barriers patients face in their everyday lives.

Adolescent↗
PubMed2025

Exploring determinants of vaccine hesitancy among healthcare professionals: a systematic literature review.

INTRODUCTION: This systematic review aims to assess determinants of vaccine hesitancy (VH) among healthcare professionals, to identify knowledge gaps and inform targeted training programs. RESEARCH DESIGN AND METHODS: A systematic search of PubMed and Scopus was conducted in February 2024. PRISMA criteria were applied, and methodological quality was assessed using a cross-sectional study evaluation tool. Studies addressing HCWs' VH determinants, including knowledge, attitudes, communication, and organizational factors, were included. RESULTS: Out of 1394 records, 221 articles were included. Reported prevalence of VH among HCWs varied across studies, reflecting differences in professional roles, settings, and vaccines studied. Key determinants included gaps in knowledge, personal beliefs, organizational barriers, and communication skills. The review highlights the importance of evidence-based information, continuing education, and effective communication in addressing VH among HCWs. CONCLUSIONS: Educational and organizational interventions are essential to improve HCWs' knowledge, attitudes, and practices regarding vaccination. Strengthening vaccine education, fostering effective communication, and addressing organizational challenges can reduce hesitancy and support HCWs in promoting vaccination among patients. Future initiatives should consider the diversity of educational settings, professional roles, and training requirements across healthcare systems.

Humans↗
PubMed2004

Break through language barriers.

Using specific phrases in Spanish to assess acute pain in non-English speaking Hispanic patients helps provide timely pain assessment and management.

Attitude of Health Personnel↗
PubMed1992

Barriers to mental health care for Hispanic Americans: a literature review and discussion.

The Hispanic American population, the second largest and fastest growing minority population in the United States, faces barriers to access to both medical health and mental health care. This paper examines both financial and cultural barriers to utilization of mental health care services; it is a broad review of the literature and is not intended to be comprehensively detailed. The research review suggests that the financial barrier is a major determinant of mental health service access for Hispanic American populations. Also, nonfinancial barriers such as acculturation are examined. A two-part plan is suggested to reduce both financial and nonfinancial barriers. Very little literature on utilization of substance abuse services was found; suggestions for further research are thus proposed.

Acculturation↗
PubMed2005

Barriers and facilitators influencing call center nurses' decision support for callers facing values-sensitive decisions: a mixed methods study.

BACKGROUND: Call center nurses triage symptoms and provide health information. However, information alone is not adequate for people facing values-sensitive health decisions. For these decisions, effective interventions are evidence-based patient decision aids and in-person nurse coaching using a structured process. Little is known about the quality of decision support provided by call center nurses. AIMS: To identify the barriers and facilitators influencing the provision of decision support by call center nurses to callers facing values-sensitive health decisions at a Canadian province-wide health call center. METHODS: A mixed qualitative and quantitative descriptive study from December 2003 to January 2004 using key informant interviews (n= 4), two focus groups (n= 7), a barriers assessment survey (n= 57), and analysis of simulated patient calls (n= 38) were carried out. Triangulation of these data was conducted using a conceptual content analysis method. RESULTS: Participants indicated positive attitudes toward call center nurses preparing callers facing values-sensitive decisions. Facilitators included decision support resources, nurses' ability to recognize callers having difficulty, and having a supportive organizational infrastructure. The most frequently identified barriers were (a) limited usability of patient decision aids via telephone; (b) lack of a structured process to guide nurses during these types of calls; (c) nurses' inadequate knowledge, skills, and confidence in providing values-sensitive decision support; (d) unclear program direction; (e) organizational pressure to minimize call length; and (f) low public awareness of the services. CONCLUSIONS AND IMPLICATIONS: Despite call center nurses having positive attitudes, several modifiable barriers were interfering with nurses' current approaches to supporting callers facing values-sensitive decisions. Nurses wanted educational opportunities to further develop their decision support knowledge and skills, and decision support resources that are easier to use via telephone. As well, changes to organizational policies that address identified barriers could further facilitate the provision of decision support.

Attitude of Health Personnel↗
PubMed1989

Working together: a consumer participation research project to develop a new model of high-support housing.

This paper outlines a participatory approach to developing a new model of service delivery for high-support housing. A consumer committee was recruited from among the inpatients and outpatients of a large psychiatric hospital in Metropolitan Toronto. Their task was to analyze three existing models of high-support housing, using structured interviews and visits, and to develop a new approach. The discussion focuses on the participation experience itself. A number of strategies were employed to reduce the traditional barriers between professionals and consumers. Using both the research results and the consumers' impressions of their experience, these strategies were evaluated for their efficacy.

Communication Barriers↗
PubMedDate not supplied

Computer use among elderly people.

This study investigates the literature on the state of knowledge on computer use among elderly people. Results of this review suggest that benefits may ensue if computer use is advocated. Functional limitations secondary to visual, hearing, and mobility changes; financial inadequacy; and cognitive limitation related to memory use are identified as barriers that may inhibit this population from learning how to use the computer. Methods and techniques dealing with these barriers are presented. Finally, teaching strategies that may be implemented to facilitate the learning process among elderly population on computer use are discussed and elucidated.

Aged↗