Background Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people’s experiences with accessing these services. A scoping review was undertaken to identify and explore research on the experience of disabled people in accessing healthcare services between 2020 and 6 February 2023. Methods PubMed, Web of Science, CINAHL, and OVID were employed to search for research that included the voice of disabled people, or their parents or caregivers. Over two distinct phases, a total of 2,201 articles were reviewed according to article titles, keywords, and abstracts. Eighty-one studies were identified that met the inclusion criteria; these were reviewed in full. Results Eighteen studies specifically described the experiences of accessing healthcare or disability services, and sixty-three raised healthcare challenges as a secondary consideration. Many disabled people struggled to access healthcare services and felt they were invisible; as a result, individuals’ mental health was negatively affected. Disabled people with compounding vulnerabilities were at the most risk of experiencing a lack of healthcare access. Conclusions There is an urgent need for research and policy that is responsive to disabled people’s access to healthcare during the pandemic; currently many health policies are ‘disability-blind’ and exclude these members of the global community. Furthermore, to assist in creating disability-responsive research, funding needs to prioritise researchers within the disabled community.
The COVID-19 pandemic significantly affected global healthcare access and exacerbated pre-pandemic structural barriers. Literature on disabled people’s experiences accessing healthcare is limited, with even less framing healthcare access as a human rights issue. This study documents and critically analyses Deaf people’s healthcare access experiences in Aotearoa New Zealand during the COVID-19 pandemic. Eleven self-identified Deaf individuals participated in semi-structured videoconferencing interviews. Discourse analysis was applied to participant narratives with discourses juxtaposed against a human rights analysis. Barriers influencing healthcare access included: (1) the inability of healthcare providers to communicate appropriately, including a rigid adherence to face mask use; (2) cultural insensitivity and limited awareness of Deaf people’s unique needs; and (3) the impact of ableist assumptions and healthcare delaying care. Barriers to healthcare access represent consecutive breaches of rights guaranteed under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Such breaches delay appropriate healthcare access and risk creating future compounding effects. Action is required to address identified breaches: (1) The CRPD should also underpin all health policy and practice development, inclusive of pandemic and disaster management responsiveness. (2) Health professionals and support staff should be trained, and demonstrate competency, in Deaf cultural awareness and sensitivity.
Introduction: The COVID-19 pandemic has affected access to health and social services globally, leading to delays in accessing appropriate care. However, while there is a growing base of research into service access for the general population, there remains scarce information on the implications of the pandemic on disabled people. This article describes issues with health and disability support access for people with impaired vision in Aotearoa New Zealand (Aotearoa). Methods: Applying an Interpretive Description methodology, 62 interviews were conducted with disabled people; 10 of these individuals identified as having impaired vision. Findings were analyzed thematically for the entire group of 62, representing varied impairment groups, and then for the 10 who had impaired vision. Results: Five key themes arose from the interviews, including transportation difficulties, mental distress, loss of community, loss of physical contact and signals, and general loss of support. Participants identified that this loss of support occurred at multiple levels, meaning that the disability and healthcare system as a whole was ill-equipped to manage their needs. Participants reported a lag-time in accessing care, meaning that the effects of the pandemic are still felt due to a lack of available support and resources. Discussion: This article remains one of a few studies to look at the implications of the pandemic on access to health and disability services for those with impaired vision. It highlights that despite Aotearoa's good track record in managing the pandemic, groups were forgotten and marginalized by the collective response to managing COVID-19. Implications for Practitioners: Blindness professionals must be aware of the possible disadvantages and impacts of pandemics and other disasters on people with impaired vision and their access to health and disability services. Policymakers must include disabled people at the decision-making table so that the diverse needs of these populations are managed.
<p>Individuals with disabilities have been acknowledged in the literature to have the same desire to travel as their able-bodied counterparts. However, participation in tourism imposes disproportional challenges for many of them and there are still various areas that need to be improved. Research on travellers with disabilities is still in its infancy and most studies concentrate on barriers and constraints to participation. Not much is known about how these constraints are being dealt with and what influence they have on travel experiences of travellers with disabilities. This study explores the travel experiences of travellers with mobility impairments, with a focus on travel constraints and the negotiation strategies. This research draws upon the author’s personal experience as a traveller with mobility impairments who has faced travel constraints and tried to negotiate and overcome those constraints. I enjoy personal travel experiences and believe travel is a fundamental right for those with disabilities. Using an approach based on the social model of disability enhanced with a degree of human agency, this research was undertaken with travellers who have some degree of privileged status in terms of access to opportunities and resources required for travel. They voice concerns and problems, but they also demonstrate human agency which is significant for their travel experiences. The study seeks better insight into the tension between travel constraints and the ability of travellers with mobility impairments to participate in tourism. Constraints, negotiation strategies, and their influence on participation are addressed across different scales: the intrapersonal, interpersonal, and structural. A qualitative methodology informed by an interpretive social sciences paradigm enables this study to access people’s experiences expressed in their own words, give voice to them to get the meaning of social interactions, and thereby explain their travel experiences. Fourteen New Zealand-based participants aged between 18 and 44 were recruited, all of whom have either a congenital or acquired a mobility impairment. In-depth semi-structured interviews were designed with a staggered approach comprising three interview sessions with each participant. Overall, 42 interview sessions with 14 participants resulted in detailed data which was analysed using a content analysis approach. The analysis focused on the travel experiences of travellers with mobility impairments which span over degrees of participation: from non-participation to partial participation to full participation. This outlined the tension between constraints and negotiation and how the final levels of participation were impacted by that tension. Travel constraints, negotiation strategies, and tourism facilitators ‒ in three levels of intrapersonal, interpersonal, and structural ‒ affected the levels of participation. Sometimes participants used negotiation strategies from a different category than the constraint; for instance, an interpersonal negotiation strategy to overcome a structural constraint. The research confirmed many of the factors identified in the literature but revealed a greater range of constraints, facilitators and negotiation strategies, including some that have not previously been explored, for example, time (constraint), resilience and determination (facilitator), and developing emotional skills (negotiation strategy). The findings also revealed that some factors could influence participation with multiple roles. Equipment and money could be constraints, facilitators, and negotiation strategies in different travel experiences. Although generalized helplessness around travel was not observed in the sample, individual incidents of feeling a sense of helplessness had an effect on participation in tourism. Participants’ disability, more specifically the type and severity of their impairments, was another determining factor for participation. Lastly, the type of trip and destination were significant in terms of constraints encountered, negotiation strategies used, and the level of participation. Participants regarded business trips as the easiest (when compared to VFR and pleasure travel) with fewer constraints that generally were easier to overcome. Most participants also regarded domestic trips as easier compared to international trips due to their familiarity with the travel context. The research brings together the theory of negotiation, the theory of learned helplessness, and the leisure constraints model into a single study to understand different levels of participation among travellers with mobility impairments. Therefore, it contributes to an understanding of the travel experiences of travellers with mobility impairments in the New Zealand context and the implications of disabilities for travel. Hence, the research hopes to promote the changes required to improve the travel experiences of travellers with mobility impairments. Based on the theoretical and practical contributions of the study, several recommendations are provided for the tourism industry and the policy-makers. These recommendations aim at moving towards a more inclusive and fair tourism for travellers with disabilities.</p>
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