"Patient and public participation in health care delivery"
By Dr. Catarina Samorinha
Postdoctoral Research Associate, Improving Health Care Delivery and Medicines Use Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
Date/Time: Wednesday, April 14, 2021 at 2:00PM
Venue: MS Teams Click here to join the meeting
Patient-centred care is widely recognised as a foundation to safe, high-quality healthcare. It is care that is respectful of, and responsive to, the preferences, needs and values of the individual patient.
In this seminar, I will present three studies in which I have been involved related to patient- centred care in the United Arab Emirates (UAE). The first study aimed to assess COVID-19 vaccination acceptability among university students in the UAE. To be effective, vaccination programs should be able to enroll high proportions of the population to achieve herd immunity. However, vaccine hesitancy and refusal reach considerable proportions globally. Our mixed- methods study with 669 students of the University of Sharjah revealed a vaccine hesitancy of 31.8%, while 24.4% of the students had a high intention to be vaccinated and 43.8% were already vaccinated. Vaccine hesitancy was predicted by negative beliefs and attitudes about the COVID-
19 vaccination (OR=0.550; 95%CI:0.460-0.657), the perception of high adverse effects (OR=1.732; 95%CI:1.491-2.011) and of worse access to the vaccine (OR=0.825; 95%CI:0.744- 0.918).
The second study focused on shared decision-making (SDM) in the clinical context. SDM has been described as a process in which clinicians and patients are involved in information exchange, express treatment and disease management preferences, and agree on a decision. This approach supports better-informed decisions that are congruent with patients' values. This cross-sectional study aimed to assess Arabic-speaking patients' preference for involvement in decision-making and characterize people who preferred to be involved in decision-making. Based on a sample of
516 patients with chronic diseases, this study showed that only one-in-four participants preferred SDM. After adjustment, not being married (OR=1.634; 95%CI:1.049-2.544) was as a predictor of preferred involvement in decision-making, while having unanswered questions (OR=0.612; 95%CI:0.393-0.954) and problems in self-care were predictors of a preference for paternalistic decision-making (OR=0.423; 95%CI:0.181-0.993).
The third study focused on one of the most prevalent chronic diseases in the Arab population, type 2 diabetes. It aimed to assess and compare diabetes distress (DD) and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants (n=392) and English-speaking patients of Anglo-Celtic background (n=304) with diabetes. Through a multicentre cross-sectional study with 696 patients, we concluded that compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self- efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. The implications of the results from these studies will be discussed.
Catarina Samorinha joined the Research Institute for Medical and Health Sciences (RIMHS) as a postdoctoral Research Associate in September 2020. She is a member of the Research Group "Improving Health Care Delivery and Medicines Use", coordinated by Dr. Hamzah Alzubaidi. She obtained her Ph.D. in Public Health from the Faculty of Medicine, University of Porto, Portugal (awarded with a grant from the Portuguese Foundation for Science and Technology), a MSc in Clinical Psychology and a BSc in Psychology (both from the University of Minho, Braga, Portugal). Her research has been focused on producing knowledge aimed at improving health care delivery in chronic diseases and developing people-centred health services, policy and practice, through the inclusion of patient and professionals' experiences and perspectives in research. She mostly develops mixed methods research (quantitative and qualitative data).