Background There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice. Methods A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes. Results Interprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions. Conclusion Geriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.
The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults.
Injury among older adults is a serious health concern, but little information is known about it, particularly in developing countries. This study aimed to determine the prevalence of, and examine the socioeconomic, demographic, and health determinants of, self-reported injuries among older Filipinos. Using a pooled data of 21,316 community-dwelling residents aged 60 years or over from three waves of the Philippine National Demographic and Health Survey, multivariate logistic regression analyses were performed to assess the relationship between participants’ characteristics and reports of injuries. The total prevalence of self-reported injuries over a 10-year period was at 1.2%. Older adults with either government or private health insurance were more likely to report experiencing injuries (adjusted odds ratio (AOR) 1.55, 95% confidence interval (CI), 1.14–2.11), regardless of socio-demographic and economic status. In contrast, female older adults were found to be associated with a lower likelihood of self-reported injuries, after adjustment for other variables (AOR 0.69, 95% CI 0.53–0.88). Older adults who attained secondary education or higher also showed a lower likelihood of self-reported injuries (AOR 0.53, 95% CI 0.31–0.92). The proportion of older adults with injuries in the Philippines is still relatively low. However, preventive approaches with a special focus on gender, educational attainment, and health insurance status of older adults are warranted.
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