农村患者获得慢性病护理的经验:定性研究的系统回顾和专题综合

Elizabeth H. Golembiewski, Derek L. Gravholt, V. T. Torres Roldan, Eddy P Lincango Naranjo, S. Vallejo, Andrea Garcia Bautista, C. LaVecchia, C. Patten, S. Allen, Soumya Jaladi, K. Boehmer
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引用次数: 8

摘要

目的:获得医疗保健是农村患者长期关注的问题;然而,行政措施未能捕捉到患者获得保健服务的主观体验。本综述的目的是综合有关美国农村地区居民获得慢性病管理卫生保健服务的患者和护理人员经验的定性文献。方法检索Embase、MEDLINE、PsycInfo、CINAHL和Scopus,确定2010-2019年发表的定性研究。采用主题综合方法分析纳入研究的结果。结果共纳入62项研究,涉及1,354名独特的参与者。研究的最大份额(24.2%)集中在癌症患者的经历上,其次是行为健康(16.1%)、艾滋病毒和艾滋病(14.5%)和糖尿病(12.9%)。我们确定了与获得农村慢性病管理卫生保健服务经验相关的障碍和促进因素的4个主要分析主题:(1)驾驭农村环境,(2)驾驭卫生保健系统,(3)为慢性病管理融资,以及(4)农村生活(即独特的“农村”思维和行为方式的共同要素)。结论:在这篇综合综述中,我们发现重要的文化、结构和个体因素影响了农村患者获得和使用医疗服务的体验,包括地理和建筑环境造成的障碍和促进因素,以及独特的农村习俗。我们的研究结果可以为政策和计划提供信息,这些政策和计划既促进了访问的结构性方面,又包括文化上适当的干预措施。视觉文摘
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rural Patient Experiences of Accessing Care for Chronic Conditions: A Systematic Review and Thematic Synthesis of Qualitative Studies
PURPOSE Access to health care is a long-standing concern for rural patients; however, administrative measures fail to capture the subjective patient experience of accessing health care. The purpose of this review was to synthesize the qualitative literature on patient and caregiver experiences of accessing health care services for chronic disease management among US residents of rural areas. METHODS We searched Embase, MEDLINE, PsycInfo, CINAHL, and Scopus to identify qualitative studies published during 2010-2019. A thematic synthesis approach was used to analyze findings from included studies. RESULTS A total of 62 studies involving 1,354 unique participants were included. The largest share of studies (24.2%) was focused on the experience of patients with cancer, followed by behavioral health (16.1%), HIV and AIDS (14.5%), and diabetes (12.9%). We identified 4 primary analytic themes of barriers and facilitators associated with the experience of accessing health care services for chronic disease management in rural areas: (1) navigating the rural environment, (2) navigating the health care system, (3) financing chronic disease management, and (4) rural life (ie, common elements of a distinct “rural” way of thinking and behaving). CONCLUSIONS In this comprehensive review, we found that important cultural, structural, and individual factors influenced the rural patient’s experience of health care access and use, including barriers and facilitators posed by geographic and built environments, and distinct rural mores. Our findings can inform policies and programs that both facilitate structural aspects of access and include culturally appropriate interventions. VISUAL ABSTRACT
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