Foster and kinship carer experiences of accessing healthcare: A qualitative study of barriers, enablers and potential solutions

McLean, Karen; Clarke, Jessica; Scott, Dorothy; Goldfeld, Sharon

doi:10.1016/j.childyouth.2020.104976

Cited by 17 publications

(31 citation statements)

References 25 publications

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“…A compelling finding was that the majority of young people had negative experiences with health professionals, describing encounters where their health concerns were dismissed, ignored or not heard. Young people are often not provided opportunities to be consulted or listened to when it comes to their health (Finan et al., 2018; Smales, Savaglio, Morris, et al., 2020), and the notion of GPs ‘ticking the box’ when examining young people in OOHC has been previously identified (McLean, Clarke, et al., 2020). Young people recognised the need to be invited into conversations about their health, listened to and supported to facilitate their healthcare (Grace et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Research has identified a number of barriers to addressing and prioritising health in care, including the crisis‐driven nature of the OOHC system (Smales, Savaglio, Morris, et al., 2020), placement instability (Rock et al., 2015) and lack of support for carers (CCYP, 2019; Monson et al., 2020). Additional barriers include difficulty accessing required health documentation (i.e., disconnection from health history, McLean et al., 2020), a lack of involvement of the young person in healthcare planning (Smales, Savaglio, Morris, et al., 2020) and haphazard transition from care processes that do not comprehensively support health (Haggman‐Laitila, 2019). These barriers inherent within the OOHC system compromise health service delivery to this vulnerable population.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

‘I’m dealing with all these health issues that could have been addressed when I was younger’. Delivery of health services to Australian young people in out‐of‐home care: Lived experiences

Smales

Morris

Savaglio

et al. 2021

Health Social Care Comm

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Care‐experienced young people demonstrate significantly poor physical, social and mental health outcomes during and beyond their time in care, yet they have rarely been consulted or included in research examining their health needs to date. This qualitative paper explores care‐experienced young people's perceptions of health in care, including accessing healthcare and interacting with health professionals. The research methodology was informed by a co‐design approach through consultation with care‐experienced young people. Semi‐structured interviews were conducted with 10 young people. The findings revealed that: (1) the care system does not nurture young people's health; (2) young people in care experience difficulty accessing and navigating a complex health system; and (3) young people are not given a voice when it comes to their health. The findings provide key recommendations for practice, including the empowerment of young people through positive, responsive and trusting relationships to prioritise the health of young people in care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘I’m dealing with all these health issues that could have been addressed when I was younger’. Delivery of health services to Australian young people in out‐of‐home care: Lived experiences

Smales

Morris

Savaglio

et al. 2021

Health Social Care Comm

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“…We followed up the survey with a qualitative study of 19 carers (9 kinship, 9 foster and 1 both kinship and foster) to understand the barriers and enablers in more detail. 29 The follow-up study confirmed that paediatric and mental health care were the hardest to access and that obtaining Medicare numbers and out-ofpocket costs were barriers to health care. Additional barriers identified through the interviews included the complex consent and authorisation environment, a lack of publicly funded services, long waitlists at those that do exist and logistic challenges in attending appointments while still prioritising school and work.…”

Section: Discussionmentioning

confidence: 79%

“…We followed up the survey with a qualitative study of 19 carers (9 kinship, 9 foster and 1 both kinship and foster) to understand the barriers and enablers in more detail 29 . The follow‐up study confirmed that paediatric and mental health care were the hardest to access and that obtaining Medicare numbers and out‐of‐pocket costs were barriers to health care.…”

Section: Discussionmentioning

confidence: 97%

Foster and kinship carer survey: Accessing health services for children in out‐of‐home care

McLean

Scott

Goldfeld

2020

J Paediatrics Child Health

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Aim To explore the experiences of Victorian foster and kinship carers in accessing health services for children in their care and to quantify the frequency of potential barriers to health care. Methods On‐line survey co‐designed with the Foster Care Association of Victoria measuring carer‐reported health service engagement by a child/young person in their care, ease of service access, time to receiving Medicare number and out‐of‐pocket health‐related costs. A total of 239 foster and 51 kinship carers were recruited through email and social media by carer support agencies. Results In total, 90% of children/young people had engaged with a general practitioner. Most had engaged with dental (75%), paediatric (72%), optometry (61%) and audiology (54%) services. Mental health services were most likely to be needed but not yet received. Neither carer education nor socio‐economic status was associated with likelihood of service engagement. Carers reported that it was hardest to get appointments with mental health and paediatric services. Twenty‐seven percent had waited to see a health service because of delays in carers receiving their Medicare number. Sixty percent of carers had paid out‐of‐pocket for health services; 78% of these had not been reimbursed. Conclusion Victorian foster and kinship carers report high health service use for children and young people in their care. Mental health services were the hardest to access with the largest gap between identified need and service use. Timely access to Medicare numbers and financial support are barriers to access that could be addressed. The development of integrated paediatric health care and clinicians co‐located with child protection could also assist.

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“…This worrying nding underscores the urgent need for timely and effective interventions that could alleviate these underserved populations' caregiver burden, such as intervention programs that are tailored to these caregivers' unique unmet needs [50][51][52]. As these disadvantaged caregivers are often di cult to reach via traditional intervention measures [53,54], researchers may consider using more agile and exible programs, such as local reach programs [55][56][57][58][59] or technology-based solutions [60,61], to deliver relevant and effective health solutions to these caregivers in a convenient and cost-effective fashion.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Impact of Patients’ Disease Types on Caregiving Time and Caregiver Burden: An Analysis of the Health Information National Trends Survey

Zhou

Gelfond

2020

Preprint

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Background: Patients with different medical conditions often have distinctive caregiving needs that could result in varying levels of caregiver burden. However, despite empirical advances in this area, little is known about how patients’ disease types interact with caregiving time and caregiver burden. To bridge this gap, we examined the impact of patients’ disease types on caregiving time and burden. Methods: Data were analyzed from the 2018 Health Information National Trends Survey 5 Cycle 2. Only participants self-identified as caregivers were included in the final analysis. Data on patients’ disease types, caregiving time (i.e., caregiving duration and caregiving hours spent per week), and caregiver burden (i.e., caregivers’ self-rated health, body mass index, and psychological distress) were examined using logistic regression analysis.Results: Patients’ disease types impacted caregiving time and burden. Caregivers of patients with neurological disease spent the greatest amount of time. For caregiver burden, caregivers of patients with cancer or aging related disease experienced worst self-rated health, caregivers of patients with orthopedic disease have the greatest likelihood to be overweight or obese, while cancer caregivers experienced greatest levels of psychological distress. Conclusions: Patients’ disease types had highly varied effects on caregiving time and burden. This study underscores the need for healthcare researchers to adopt a nuanced approach in acknowledging and addressing the burden of care experienced by caregivers, such as tailoring interventions based on both patients and caregivers’ characteristics and preferences.

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Foster and kinship carer experiences of accessing healthcare: A qualitative study of barriers, enablers and potential solutions

Cited by 17 publications

References 25 publications

‘I’m dealing with all these health issues that could have been addressed when I was younger’. Delivery of health services to Australian young people in out‐of‐home care: Lived experiences

‘I’m dealing with all these health issues that could have been addressed when I was younger’. Delivery of health services to Australian young people in out‐of‐home care: Lived experiences

Foster and kinship carer survey: Accessing health services for children in out‐of‐home care

Understanding the Impact of Patients’ Disease Types on Caregiving Time and Caregiver Burden: An Analysis of the Health Information National Trends Survey

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