Browsing by Subject "Health literacy"

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    Evaluating the Influence of Patient Caretakers’ Health Literacy on Delays in Care for Traumatic Brain Injury Patients at Mulago National Referral Hospital, Uganda.
    (2019-04-24) Nwosu, Chinemerem
    Background Caretakers take on caregiving tasks such as feeding and administering oral medication for patients at Mulago National Referral Hospital (MNRH), Uganda and many Low-Middle Income Countries (LMICs) where nurse shortages are prevalent. They shoulder the burden of caretaking responsibilities with little or no knowledge of the patient care. Studies have shown that caretaker’s ability to navigate the healthcare system, find, and use health information to support their patients throughout the care continuum can impact the three delays in care: seeking, reaching and receiving care. With the life-threatening nature of Traumatic Brain Injuries (TBI) in Uganda, caretakers’ play an important role in ensuring patients access care in a timely manner. This study seeks to determine the factors that impact TBI patient caretakers’ health literacy in MNRH and examine how these factors influence the three delays in care. Methods This qualitative research study was carried out in the neurosurgical ward at MNRH, in northern Kampala. The study participants were 27 adult caretakers. Semi-structured in-depth qualitative interviews, outlined through “The Three Delay Framework”, was utilized to understand participants’ experiences with delays in seeking, reaching and receiving care for moderate to severe TBI patients. Thematic content analysis and manual coding was used to analyze interview transcripts and identify overarching themes in the participant responses. Results This study identified three main caretaker health literacy factors, each with three sub-factors, that impact the three delays to care. The main themes identified were Extrinsic, Intrinsic and Health System Factors. The nine sub-themes were Government Support, Community Support, Financial Burdens, Lack of Medical Resources, Access to Health Information, Physician Support, Emotional Challenges, Navigational Skills and Understanding of Health Information. These components were found to influence the delays to care to varying degrees. More importantly, Financial Burdens, Government Support, Emotional Challenges, Physician Support and Lack of Medical Resources were recurring health literacy factors across the three delays. Conclusion The health literacy factors identified in this study work to influence caretakers’ functional health literacy and the delays to care in a co-dependent manner. A better understanding of how these factors impact patient outcomes is necessary for the development of context and culturally relevant interventions targeted at improving a caretaker’s ability to maneuver the healthcare system and support patients in resource-poor settings. There is a strong need for the state and policy makers to invest in improving health education and communication strategies to support caretakers’ health literacy needs and mitigate the delays to care for TBI patients.
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    Increasing Glaucoma Detection in Roatán, Honduras: The Value of Education and Intraocular Pressure Screenings
    (2023-04-11) Pluenneke, Molly
    Glaucoma is an ocular neuropathy that damages the optic nerve, leading to vision loss and blindness. Insidious in its presentation and difficult to diagnose, glaucoma is asymptomatic until irreversible harm is caused. Accounting for 12.6% of preventable blindness in Honduras, glaucoma inflicts considerable clinical, economic, and personal burdens on thousands of lives (Rosa et al., 2022). Early detection and treatment halves the risk of disease progression by lowering the intraocular pressure so that permanent harm to the optic nerve is avoided (Leskea et al., 2004). However, in Roatán, where access to ophthalmic care is lacking and awareness of the disease is scarce, many cases of glaucoma go undiagnosed or are poorly managed, leading to higher rates of irreversible and avoidable blindness (Varma et al., 2011; Delgado et al., 2019). This paper seeks to understand if a two-pronged community-based strategy, which combined an educational campaign with an intraocular pressure screening, was an effective means to increase ophthalmic care seeking behavior in Roatán, Honduras. To do this, community members were given information about glaucoma and their pressure was taken with an iCare tonometer. Those with elevated pressures were recorded and contacted about follow-up. These data were then compared to the number and identity of patients who sought out ophthalmic care during a one-week medical brigade on the island to determine if the community-based approach was effective in increasing screening and detection of glaucoma. With a 7.56% follow-up rate, the analysis determined that the implemented strategy was ineffective. This study reveals a lack of timely follow-up in Roatán, demonstrating limitations in the utilized method of screening and referral. Additional interventions should be examined to determine more successful methods to increase detection of glaucoma in Roatán.