Barriers to Healthcare for Diabetic Ethnic Minorities

Barriers to wellnessc be for Diabetic Ethnic MinoritiesComparing Barriers to Health flush in Diabetic Ethnic Minorities in Urban Versus Rural SettingsNoreen ChoudharyIssue/ businessThere has been abundant inquiry d one(a) in the deliberate of heathenish minorities and their gateway to health c be. Attention has been paid to common bars such as language, cognition and communication, which argon all culturally influenced. Most of this inquiry has foc expendd on general get on shotion shot to healthcare and not specific illnesss. There is actually little reserach on comparing barriers that come by and through depending on hole. The issue I would be exploring in my guide is determining the differences in likely barriers that exist in access to healthcare among heathenish minority diabetic individuals in urban versus rural settings. The potential barriers in access should differ depending on the location since the type and amount of resources record varies in both se ttings. This study hopes to contri exactlye to the literature by focusing on diabetes and determining the differences in barriers that exist for social minorities in the urban versus rural settings.BackgroundThe regions with the sterling(prenominal) incidence of diabetes are Africa and Asia, where the rates are expected to rise cardinal or three times (Oldroyd, Banerjee, Heald Cruickshank, 2005). The three countries with the heightsest prevalence of diabetes are USA, china and India (Oldroyd et al., 2005). The largest increases are expected in Brazil, Indonesia, Bangladesh , Pakistan and Japan (Oldroyd et al., 2005). Type 2 diabetes is near common among heathen minority assorts residing in developed countries (Oldroyd et al., 2005). Diabetes is a inveterate illness that requires continuing medical attention as well as self-management education (American Diabetes Association, 2002).Renfrew et al. (2013) reported on barriers to care benefaction in a Kampuchean population ne ar Boston. The study highlighted the importance of a culturally sensitive healthcare governance for Cambodians (Renfrew et al., 2013). The headwayers bear the following barriers in access to healthcare patients views of chronic disease, diabetes management, communication, psycho- loving agentive roles, diabetes etiology and explanatory theoretical accounts and fears of interacting with the healthcare system (Renfrew et al., 2013). The investigators were advocating for a culturally sensitive approach to healthcare for this population beca example most of the barriers determine were culturally influenced. Some of these culturally influenced barriers were patients mistrust in the western model of health, replacement by alternative medicine, belief that western medicine is an moment cure, and desire to please the practicians (Renfrew et al., 2013). Researchers give these barriers among other which were influenced by cultural beliefs of the patients (Renfrew et al., 2013).Smit h, Garie, and Schmitz (2014) illustrated self-reported employ of diabetes healthcare services in a Quebec community-based sample. The study found that masses with major depression were much(prenominal) likely to be high users or non-users of diabetes healthcare services (Smith, Garie, Schmitz, 2014). People with major depression reported much problems with accessing diabetes healthcare services (Smith, Garie, Schmitz, 2014). People with major depression comprehend more problems with the healthcare they received (Smith, Garie, Schmitz, 2014). The results also showed that large number with major depression perceived problems with the length of time they had to wait to see a doctor, that there is a neglect of specialist care in their area and are more likely to report having problems getting to the doctor due to transportation and health problems (Smith, Garie, Schmitz, 2014). The low service users represent a particularly vulnerable group who may privation to be targeted by interventions in order to further them to visit a doctor (Smith, Garie, Schmitz, 2014). The finding in this study was of import because it showed that perceived problems with accessing healthcare services could impact utilization of healthcare.Wagner et al. (2013) reports on the do of trauma on the risk for disease development and access to healthcare. amiable health problems among south-east Asian refugees are well known scarce the long term affects of mass violence as re-settled refugees age are less well described (Wagner et al., 2013). This study investigated both potential relationship that may exist between trauma symptoms, self-reported health outcomes, and barriers to healthcare among Cambodian and Vietnamese persons in Connecticut (Wagner et al., 2013). Healthcare access and occurrence were deliberate regarding patient-provider chthonicstanding, cost and access, and interpretive services (Wagner et al., 2013). Individuals with greater levels of trauma symptoms were associated with greater lack of actualiseing, cost and access problems, and the need for an interpreter (Wagner et al., 2013). Although these Southeast Asian immigrants arrived to get together States as refugees more than 20 years ago, there continues to be high levels of trauma symptoms among this population which are associated with increased risk for disease and decrease access to healthcare services (Wagner et al., 2013). This article was interesting because it didnt imply the usual barriers we talk just about when it comes to access to healthcare (such as language).The stand article I found was titled, Diabetes care quality is a headspring of location by The military press Association. The article talks about the mensuration of diabetes healthcare in England depending on a postcode lottery (The weigh Association, 2013). The quality of care patients receive depends whether its provided by a GP or a hospital, it depends on the location (The librate Association, 20 13). The report found big regional differences in patients access to quality, integrated care (The Press Association, 2013). Some areas were four times more likely to get yearbook checks needed to manage their conditions (The Press Association, 2013). This article is similar to my look into encounter however instead of rural and urban settings, it focused on location in scathe of where healthcare was sought, a clinic, hospital, or GP (The Press Association, 2013).Purpose/Aim of your ProjectThe aim of my seek proposal is to put down any potential barriers that may exist in access to healthcare among ethnic minority diabetics in rural versus urban settings. My original enquiry proposal was investigating potential barriers in access to healthcare among ethnic minority diabetics without the location promoter. When I started looking up literature, I found there was already enough information in this area and my research wouldnt add anything distinctive to this field. I started re ading more articles and doing a literature review, I didnt find any studies comparing potential barriers in urban and rural settings. After reviewing the comments I received from the professor after the first assignment, I was actively looking for gaps in research when reading articles. Therefore, I decided to alter my original question after I found this gap. If there are differences in the types of barriers present in these ii distinct settings, then hopefully my research would bring this to the psyche of healthcare providers and policymakers and would result in equitable care in urban and rural settings.Rationale/justificationCanada is known for its multiculturalism with Ontario being the most ethnically diverse province 3. Almost 13.4% of Canadians identified themselves as being a visible minority in the 2001 census 3. Since diabetes is most prevalent in ethnic minorities and Canada is one of the most ethnically diverse countries, its intelligible why there is an abundance of research in this field.There is a currently a gap in research that my research would potentially fulfill. While reading articles present in my field of interest, I couldnt find any that comparabilityd barriers in access to healthcare present in urban versus rural settings. This sort of information is necessary for policymakers to reduce or even eliminate these barriers to contact high quality of care for diabetic individuals in the future. If the results conclude that the barriers present in the urban settings differ from the ones present in the rural setting, then there is work to be done. We essential ensure health equity when it comes to access to healthcare and eliminate any geographical factors that come into play. We must ensure healthy places for all individuals scarce especially diabetics who require a lot of loving and medical support. Also, the need for culturally appropriate health care to accommodate the unique inevitably of ethnic minorities. The other research g ap I found was studies didnt talk about information loss during translations, either during patient and practitioner interactions or researcher and patient interactions. I think its an main(prenominal) factor to consider in studies consisting of subjects who speak another language. For instance, in one study the researchers found that patients didnt understand the concept of chronic disease and I hope that this was due to information loss during translation. Therefore, the purpose of this study is to provide healthcare professionals with information on the contrary barriers that exist among urban and rural settings in order to achieve health equity.Researchable research questionThe research question for my study is What are potential barriers in access to health care among ethnic minorities with diabetes in the urban versus the rural settings? able guidepostsOntology is the theory of being or what man importantly is, in social sciences it is closely linked with ethical implicat ions (David Sutton, 2011). The base premise of phenomenological ontology is that for humans candor is not something separate from its appearance (David Sutton, 2011). The way we think about ourselves is fundamental to what we are (David Sutton, 2011). For me, I think that health is a fundamental horizon of being human, its a basic right and an underlying factor in our existence. All individuals should have access to healthcare and this access should be equitable, regardless of ones location.The particular epistemological (theory of knowledge) stance (positivist, searing theoretical or interpretivist) result be grounded in assumptions about the basic character of being human (David Sutton, 2011). My research project is rooted in the interpretivist paradigm because I believe that access to healthcare is an important verbalism of being human. Health is an important part of being human and to achieve this health, we need a culturally sensitive and acceptable healthcare system for ethnic minorities.Axiology is about the appreciates each individual has and its influence on their research print. There are no value-free sociologies, values are foundational for knowledge-producing systems print. The composition of this study began with a personal experience I have with diabetes but eventually filtered out to form a researchable question that could add value to the field. Coming from a background in biology, we are taught that there is something do by with the body and it needs to be fixed, that health is solely a biologic factor. This was purely based in a positivist paradigm which is line up with quantitative research. I believe that healthcare access regardless of ethnicity, location, age, sex, or gender is crucial for all humans. Coming from a country with a poor healthcare system also influences my view in terms of healthcare access. I believe that health has a strong social component which cannot be measured quantitatively and thus I pick out an in terpretivist and qualitative approach for my study.The best way to undergo my study would be by utilizing a qualitative approach, more specifically, open-ended interviews. I motive to gain brain wave into the barriers that are present for each individual from these ethnically diverse backgrounds. I destiny to understand their perspective and beliefs, and how these influence their use of the healthcare system. After I understand these barriers, I will compare the difference in the types of barriers that are present among those living in the urban and rural settings. Since I am using open ended interviews, I believe the best rhetorical choice would be passive. I believe the participants in the study should have the freedom to talk in learning about the issue at hand. I dont exigency to influence their answers in any way but at the kindred time they should have the opportunity to freely express themselves. Especially in my study which includes ethnic minorities, there may be lang uage barriers present so this freedom to answer freely would be a confident(p) for the participants.Interpretive/theoretical frameMy research project will be embedded in the interpretive paradigm. More specifically, I will be adopting the constructionism theory. Constructionists focus on how people piss meaningful social reality for themselves through their interactions and thereby create a sense of order through shared beliefs (David Sutton, 2011). Constructionists adopt qualitative approaches such as interviews and unstructured manifestation (David Sutton, 2011). I believe that culture is important in defining health, it influences our deportment in terms of how we access and utilize our healthcare system. For example, Renfrew et al. (2013) talked about how peoples perceptions on chronic illness affected their use of the healthcare system. Ones culture, beliefs, views and attitudes affects their behaviour in terms of healthcare use. This is pertinent to my research project because I want to understand the barriers that exist for ethnic minorities with diabetes but with the added element of comparing these barriers in two settings urban and rural.ReferencesAmerican Diabetes Association. (2002). Standards of medical care for patients with diabetes mellitus. Diabetes Care, 25, 533-549.David, M., Sutton, C. (2011). Social research An introduction. London Sage Publications.Oldroyd, J., Banerjee, M., Heald, A., Cruickshank, K. (2005). Diabetes and ethnic minorities. Postgrad Medical Journal, 81, 486-490.Renfrew, M. R., Taing, E., Cohen, M. J., Betancourt, J. R., Pasinski, R., Green, A. R. (2013). Barriers to care for Cambodian patients with diabetes Results from a qualitative study. Journal of Health Care for the Poor and Undeserved, 24(1), 633-655.Smith, Garie, Schmitz (2014). Self-reported use of diabetes healthcare services in a Quebec community-based sample impact of depression status. Public Health, 128, 63-69.The Press Association. (2013, Decembe r 10). Diabetes care quality is question of location. Nursing Times. Retrieved from http//www.nursingtimes.net/home/clinical-zones/diabetes/diabetes-care-quality-is-question-of-location/5066307.articleWagner et al. (2012). Trauma, healthcare access, and health outcomes among Southeast Asian refugees in Connecticut. Journal Immigrant Minority Health, 15, 10651072.Peer Feedback FormIs it make pass what issue or problem the root will investigate through this study? Explain.Yes, the author is studying healthcare access by immigrants from two different backgrounds those from developed countries and those from underdeveloped countries. It is evident in the assignment what the researcher will be trying to determine and why they have elect to do so. There is a gap in understanding barriers in access to healthcare that exist between immigrants from developing countries and those from developed countries.Is the approach chosen, qualitative or quantitative a worthy choice, and will it bring insight into the research question? Explain.The approach is qualitative and this is a suitable choice. Since the researcher wants to understand why people over or under use the healthcare system and wants their opinion/views, its best to use a qualitative approach. By using interviews, for example, they can gain insight into the factors that influence people to use or not use the healthcare system in their country.Has the author explained connections to the literature, including what gaps exist in our knowledge about the topic? Explain.Yes, the author has put acrossly explained why they want to do this research and what gap it will fill. They have mentioned that previous research has been done on immigrants and access to healthcare, however, none have focused on the differences in this access based on country of origin (developed/developing).Are the aims of this project clear and well written? Explain.Yes, the aims are quite clear. The author wants to understand the factors that foreclose immigrants from using the healthcare system based on their country of origin, the occidental or Eastern countries. They want to compare these factors and understand if any differences exist.Is the research question clearly stated? Is it researchable? Does it fit well within approach the author has selected? Explain.The question is clearly stated and is researchable. It will fit with the qualitative approach that the researcher has chosen because it will allow them to understand from the immigrants views why they chose or didnt choose to utilize the healthcare system. They want to understand the barriers that exist for them individually and thus, the best approach is to use qualitative methods.Has the author properly and convincingly used the intellectual guideposts for research, explaining her or his project and position relative to these? Explain.Yes, the author used the intellectual guideposts to explain her position on each one. The use of the constructionism theory in this research proposal makes sense. They want to understand the barriers that exist for each individual and this is influenced by how people create and perceive their realities, the basis of constructionism.Is it clear which paradigm and theoretical frame will be used in this study? Explain.It is quite evident that this research is based on the interpretive paradigm. As she stated in this assignment, The largest factor guarding our interpretations of the social world is culture. This perfectly fits with this research study because Im sure that most of the barriers that exist in access to healthcare are influenced by culture. This is especially true for most immigrants who come from countries that are different culturally.What suggestions can you make or ideas can you bring to enhance the boilersuit clarity of the proposal? Explain.Overall the assignment was very well done, however, Im just wondering if you are concentrating on new or long term immigrants. I think this would potenti ally affect the types of barriers that are present. For example, language or knowledge would be more of a barrier for newer immigrants. Maybe you could control for this aspect, as it could be a potential confounder. heartfelt luck1