Multi-level strategies to improve equitable timely person-centred osteoarthritis care for diverse women: qualitative interviews with women and healthcare professionals

International Journal for Equity in Health

Research

Cornelia M. Borkhoff¹  Aisha Lofters²  Anna R. Gagliardi³  Marisa Battistella³  Madeline Theodorlis³  Angelina Abbaticchio³  Glen Stewart Hazlewood⁴  Deborah Marshall⁴  Crystal MacKay⁵  Vandana Ahluwalia⁶ 

[1] Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, M5G2C4, Toronto, ON, Canada;University of Calgary, 2500 University Drive NW, Calgary Alberta T2N1N4, Canada;West Park Healthcare Centre, 82 Buttonwood Ave, M6M2J5, York, Canada;William Osler Health System, Brampton, ON, Canada;

关键词: Osteoarthritis;    Women’s health;    Access;    Person-centred care;    Health care quality;    Inequities;    Barriers;    Implementation strategies;    Qualitative interviews;   

DOI  :  10.1186/s12939-023-02026-x

 received in 2023-06-21, accepted in 2023-09-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWomen are more likely to develop osteoarthritis (OA), and have greater OA pain and disability compared with men, but are less likely to receive guideline-recommended management, particularly racialized women. OA care of diverse women, and strategies to improve the quality of their OA care is understudied. The purpose of this study was to explore strategies to overcome barriers of access to OA care for diverse women.MethodsWe conducted qualitative interviews with key informants and used content analysis to identify themes regarding what constitutes person-centred OA care, barriers of OA care, and strategies to support equitable timely access to person-centred OA care.ResultsWe interviewed 27 women who varied by ethno-cultural group (e.g. African or Caribbean Black, Chinese, Filipino, Indian, Pakistani, Caucasian), age, region of Canada, level of education, location of OA and years with OA; and 31 healthcare professionals who varied by profession (e.g. family physician, nurse practitioner, community pharmacist, physio- and occupational therapists, chiropractors, healthcare executives, policy-makers), career stage, region of Canada and type of organization. Participants within and across groups largely agreed on approaches for person-centred OA care across six domains: foster a healing relationship, exchange information, address emotions, manage uncertainty, share decisions and enable self-management. Participants identified 22 barriers of access and 18 strategies to overcome barriers at the patient- (e.g. educational sessions and materials that accommodate cultural norms offered in different languages and formats for persons affected by OA), healthcare professional- (e.g. medical and continuing education on OA and on providing OA care tailored to intersectional factors) and system- (e.g. public health campaigns to raise awareness of OA, and how to prevent and manage it; self-referral to and public funding for therapy, greater number and ethno-cultural diversity of healthcare professionals, healthcare policies that address the needs of diverse women, dedicated inter-professional OA clinics, and a national strategy to coordinate OA care) levels.ConclusionsThis research contributes to a gap in knowledge of how to optimize OA care for disadvantaged groups including diverse women. Ongoing efforts are needed to examine how best to implement these strategies, which will require multi-sector collaboration and must engage diverse women.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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