Educational Intervention to Improve Citizen’s Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Intervention
2.3. Instruments
2.3.1. Questionnaire
2.3.2. Interview Guide
2.3.3. Procedure
2.4. Analyses
2.5. Ethical Approval
3. Results
3.1. Demographic Data
3.2. Difference in Citizens’ Perceptions of Participation in Health Management and Collaboration with Healthcare Professionals between the Intervention and Control Groups
3.3. Difficulties Faced by Rural Citizens Participating in Health Management and Collaborating with Healthcare Professionals
3.4. Ability to Manage Health Conditions
3.4.1. Difficulty in Judging Symptoms
3.4.2. Limited Collaborative Experience
3.5. Relationship with Medical Professionals
3.5.1. Hierarchy in Healthcare
3.5.2. Feelings of Low Self-Efficacy
3.6. Relationships among Citizens
3.6.1. Weakening Relationships among Citizens
3.6.2. Anxiety about Privacy
3.6.3. Cultural Norms
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No | Heading | Revised Items |
---|---|---|
1 | Having dialogue with health-care staff | Having good conditions for mutual communication with health-care staff is essential. |
2 | My knowledge and preferences regarding my care should be respected. | |
3 | Health-care staff should listen to you. | |
4 | Sharing knowledge | I want to get explanations for my symptoms/issues. |
5 | I would like to tell about my symptoms/issues. | |
6 | Health-care staff should explain to me the procedures to be performed/that are performed | |
7 | Partaking in planning | I should know what is planned for me. |
8 | I would like to take part in the planning of my care and treatment | |
9 | I want to be able to phrase personal goals. | |
10 | Managing self-care | I would like to perform self-care e.g., managing my medication or changing dressing. |
11 | I prefer to manage self-care e.g., adjusting diet or performing preventive health care. | |
12 | I would like to know how to manage my symptoms. |
Crude | After Propensity Score Weighting | |||||
---|---|---|---|---|---|---|
Variables | Intervention (n = 122) | Control (n = 119) | p-Value | Intervention (n = 71) | Control (n = 71) | p-Value |
Gender, (male: N, %) | 57 (46.7) | 60 (50.4) | 0.607 | 33 (46.5) | 34 (47.9) | 1 |
Age in years (M, SD) | 71.38 (3.38) | 68.58 (3.14) | <0.001 | 69.58 (2.89) | 69.89 (3.24) | 0.549 |
Primary care physician (Nyes, %) 1 | 89 (72.9) | 89 (73.6) | 0.156 | 55 (77.5) | 53 (74.6) | 0.846 |
Chronic diseases (Nyes, %) 2 | 98 (80.1) | 88 (73.9) | 0.283 | 54 (76.1) | 51 (71.8) | 0.703 |
Employment (Nyes, %) 3 | 85 (69.7) | 89 (74.8) | 0.473 | 51 (71.8) | 55 (77.5) | 0.563 |
Self-rated health (Nhigh, %) 4 | 89 (73.0) | 91 (76.5) | 0.392 | 51 (71.8) | 54 (76.1) | 0.703 |
Headings in study questionnaire | ||||||
Having dialogue with healthcare staff (SD) 5 | 12.55 (1.37) | 12.83 (1.30) | 0.116 | 12.75 (1.33) | 12.75 (1.32) | 1 |
Sharing knowledge (SD) | 12.94 (1.07) | 13.17 (1.40) | 0.161 | 13.06 (1.13) | 13.04 (1.53) | 0.95 |
Partaking in planning (SD) | 12.17 (1.40) | 12.10 (1.48) | 0.706 | 12.28 (1.28) | 12.01 (1.41) | 0.238 |
Managing self-care (SD) | 12.05 (0.93) | 12.02 (1.55) | 0.845 | 12.13 (0.97) | 11.82 (1.46) | 0.138 |
Variables | Crude | After Propensity Score Weighting | ||||
---|---|---|---|---|---|---|
Intervention (n = 122) | Control (n = 119) | p-Value | Intervention (n = 71) | Control (n = 71) | p-Value | |
Having dialogue with healthcare staff (SD) 1 | 12.68 (1.12) | 12.83 (1.34) | 0.342 | 12.80 (1.23) | 12.76 (1.34) | 0.845 |
Sharing knowledge (SD) | 13.18 (1.19) | 13.13 (1.41) | 0.784 | 13.30 (1.24) | 13.00 (1.50) | 0.202 |
Partaking in planning (SD) | 12.39 (1.02) | 12.14 (1.41) | 0.115 | 12.62 (0.88) | 12.04 (1.35) | 0.003 |
Managing self-care (SD) | 12.43 (1.04) | 11.96 (1.60) | 0.007 | 12.49 (1.01) | 11.76 (1.53) | 0.001 |
Theme | Concept | Quotes |
---|---|---|
Ability to manage health conditions | Difficulty in judging symptoms | Through this workshop, I could confirm the importance of us participating in health management and collaborating with healthcare professionals. However, although I know that we should visit medical institutions if we have medical problems, to get healthy, we cannot determine the seriousness of our symptoms. We find medical issues confusing. (Interviewee B) |
Limited collaborative experience | This was our first time understanding the importance of health management and collaboration with healthcare professionals. I understand that we should participate in the collaboration. However, overall, we do not know each professional’s work and how they collaborate between themselves. I want to learn more about each profession. (Interviewee K) | |
Relationship with medical professionals | Hierarchy in healthcare | We are used to following a physician’s decisions. When it comes to treatment, I cannot imagine a situation in which I can provide my opinion on such decisions. Also, we do not have appropriate medical knowledge, and following their choices may be safer for us. (Interviewee M) |
Feelings of low self-efficacy | We understand the importance of health management and collaboration with healthcare professionals and our participation in it. I am interested in it, but I do not feel any confidence while doing it. It may be the result of our lack of experience or limited understanding of the collaboration. I cannot say correctly. We may need more education in this regard. (Interviewee O) | |
Relationship among citizens | Weakening connections among citizens | Times have changed. In the past, we could help each other when we were in trouble. Especially when we had certain symptoms, some neighbors consulted medical professionals for us, which enabled early diagnosis and better treatments. However, in the present community, the loose connections between citizens prevent such collaborations, which may lead to the delayed treatment of critical diseases and mortality. (Interviewee K) |
Anxiety about privacy | Now, we are very anxious about privacy and cannot share information easily, even in rural communities. Of course, privacy is essential if we want everyone to be secure in their homes. However, too much is dangerous, especially in rural areas where there are only limited resources. To collaborate with medical professionals, we must balance our need for privacy and safety. (Interviewee G) | |
Cultural norms | We may need help in reality, but we may not feel it. Everybody must think so, when they manage to live by themselves, and in the later stages of their lives, they have to ask for some help. This trend may be strong in rural areas. (Interviewee C) |
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Ohta, R.; Ryu, Y.; Kitayuguchi, J.; Sano, C.; Könings, K.D. Educational Intervention to Improve Citizen’s Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study. Int. J. Environ. Res. Public Health 2021, 18, 1782. https://doi.org/10.3390/ijerph18041782
Ohta R, Ryu Y, Kitayuguchi J, Sano C, Könings KD. Educational Intervention to Improve Citizen’s Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study. International Journal of Environmental Research and Public Health. 2021; 18(4):1782. https://doi.org/10.3390/ijerph18041782
Chicago/Turabian StyleOhta, Ryuichi, Yoshinori Ryu, Jun Kitayuguchi, Chiaki Sano, and Karen D. Könings. 2021. "Educational Intervention to Improve Citizen’s Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study" International Journal of Environmental Research and Public Health 18, no. 4: 1782. https://doi.org/10.3390/ijerph18041782