Healthcare Assignment: Protocol Systematic Review On Barriers & Facilitators To Healthcare Access For Disabled People

Question

Task:
Conduct a thorough research and prepare a healthcare assignment presenting a protocol systematic review of topic-"Facilitators and barriers to accessing healthcare services among disabled people"

Answer

Identify PICO

The research question for the research on healthcare assignment includes 

• Do the facilitators help disabled people in accessing healthcare services? 

• Do the barriers prevent disabled people from receiving healthcare services? 

• Is the following research going to help in recognising the significant facilitators and videos for the healthcare services? 

Define inclusion and exclusion criteria

Inclusion criteria in research are the consideration of factors that help in choosing the most important source for data that would give maximum accurate information for the study. For the qualitative study, inclusion criteria help in developing a constricted data pool while using the critical data in completing the study based on the outcome retrieved from the data pool (Patino & Ferreira, 2018). The exclusion criteria highlight specific characteristics which need to be considered while receiving data and avoid specific characteristics that are ineligible for the study. The use of inclusion and exclusion criteria helps in maintaining a particular focus while removing all the irrelevant and duplicate information from the study. 

Search strategy

The research strategy appointed for the study involves recognising the participant. In the case of qualitative study, the participants are the literature pieces that help in retrieving effective information. Therefore, before choosing effective literature pieces, the first step is to recognise the keywords which will be used for searching relevant articles in different online sources and libraries. Therefore, the keywords for this study are as follows.

Facilitators, barriers, disabled people and healthcare service

All the articles would be based on these keywords to ensure that only those articles having a direct link to the study would be considered as the data sample.

The next step is to start the search by using the keywords in effective libraries where a list of articles will open. All the duplicate articles would be removed by filtering the search bar and recognising their inclusion and exclusion criteria to execute further filters in the search engine. 

The inclusion criteria for the qualitative study will consider the existing literature pieces that elaborate on the information related to the facilitators and the periods for receiving healthcare support among disabled people. The inclusion criteria would include choosing journal articles that have been published after 2017 and are in the English language. Specifically, the article published after 2017 would be considered because the articles published before five years May not have the relevant information as it is considered to be an old article. For a qualitative study, the focus on the recent data and research is executed by researchers is important. Therefore, the entire focus will be on looking into articles published after 2017 (Eriksen & Frandsen, 2018). Only those articles published in English would be considered as it helps in maintaining the concentration of the researcher, while the article would be easy to interpret for any readers who have an interest in the healthcare facilities while recognising the barriers for the disabled people. 

The exclusion criteria involve excluding those articles which do not give any relevant information regarding the facilitator or the barrier having an influence over their accessibility of healthcare services for disabled people. Also, those articles which are published in any language other than English would be excluded along with those articles published before 2017. The exclusion criteria are followed to maintain the phenomena of interest where the researcher is able to maintain the exact context of the research. 

The maintenance of search strategy based on keywords, inclusion and exclusion criteria can be completed by using the screening process. Finally, those articles which require membership would be excluded. In simple words, only open-source articles would be considered in the data pool as it would allow the readers to verify the information retrieved from different articles and check the credibility of the study. Therefore, the maintenance of exclusion and inclusion criteria is important to execute the data collection process in a qualitative study (Weaver et al., 2020). For the study regarding facilitators and barriers in healthcare service for disabled people, the maintenance of inclusion and exclusion criteria holds a special mention because the research would be highly engaged in recognising prospects for the disabled people to receive healthcare support.

Types of study

The following review will focus on qualitative data while including different types of studies such as qualitative descriptive work, ethnography, phenomenology and grounded theory. Different types of data would be included in the study that is necessary for maintaining a continuous approach and ensuring that all the perceptions and the point of view of different authors are included to create a positive outcome of the study. The types of study considered involve multiple types because focusing on the multiple studies would help in creating a diversified perception of the study while highlighting the relevant information and avoiding bias in the study. 

Information sources

The information source involves focusing on databases such as ECU Worldsearch, MEDLINE, CINAHL and PubMed. For retrieving grey literature pieces that can be used in the study, Google scholar would be considered as the most competent information source. While creating the reference list, all the identified reports and articles would be considered to maintain the ethical consideration in the study. Also, the effectiveness can be verified by maintaining their inclusion and exclusion criteria. MEDLINE is a bibliography database specialising in biomedical and life science information, which includes bibliography information from different academic journals while maintaining the focus on healthcare perception. The use of MEDLINE would be effective as it mainly holds information regarding the healthcare services available for disabled people and gives the most recent information based on the most recent research. Subsequently, CINAHL is another index for journal articles regarding healthcare and biomedicine. MEDLINE is a free database, whereas CINAHL requires a subscription. ECU Worldsearch is the database for ECU that allows the students to access millions of journals books and articles for free.

Google Scholar is another database that is available for searching scholarly literature and has no focus on specific subjects. The focus on Google scholar should be considered as a secondary concern where the majority of the articles would be retrieved from MEDLINE. Google scholar is also a free database that holds relevant information. However, extensive use of Google scholar can create a bias in the study because of the diversified information and literature pieces available on Google Scholar. In addition to the use of different online databases, Endnote X8 would be considered to remove all the duplicate articles and maintain consistency in the data added to the data pool for the research (Joda, Zarone & Ferrari, 2017). Therefore, out of all the available databases, ECU Worldsearch is the most appropriate and relevant source for information that would maintain the credibility of the entire study. 

Assessment of methodological quality and provide rationale for the selected tool

The process of conducting the assessment of the methodological quality is mainly initiated by the articles and journals which are properly engaged by the eligibility of the inclusion criteria. This assessment will be relied on by the researcher for validating the methodological quality. The research will mainly analyse the barriers and facilitators for disabled individuals to access health care services. According to Ma et al. (2020), the accessing barriers in healthcare services are mainly dispersed by the availability, improper transpiration, lack of drugs and huge cost. Therefore, this research will analyse the articles and journals which have the information regarding these barriers. The researcher will develop their perception for generating the review in a proper manner along with identifying the effective facilitators who have the capability to provide better access for disabled people. The methodological quality will also be maintained by assessing the entire study on the basis of the remaining articles after the excluded ones. It will provide an effective benefit of no gap in the dignity of the data along with utilising all the potential information in the review and the appropriateness of the methodological approaches will be proved. It is also important to note that it will also assure the actual meaning of the study captured by the researcher. The assessment of the methodological quality will also indicate the acceptable tools for controlling the real case scenario (Hosain & Chatterjee, 1998). It has the capability to provide all the critical checklists by which the articles and journals from the verified researchers will be taken in an effective manner. 

The selected tools for assessing the methodological quality is cross-sectional study will also help in resolving the disagreement for the reviewer as it is important to resolve the conflict by potential discussion of logical reasoning.Cross-sectional study will provide an efficient disclosure for the specific disagreement that develops unity and they will be committed to figuring out the missing information for the additional data which will clarify the conflict on the basis of the requirement (Weaver et al., 2019). The effective utilisation of the quality assessment tool for the methodology will enhance the data integration and synthesis process which will motivate the reviewers and hay to instruct proper knowledge for the readers along with prioritising the internal validity of the study. As defined by Jung et al. (2021), the proposed systematic review will analyse the actual importance of the preliminary literature review by which the researcher will collect the current information from the authentic websites along with the potential data that will be collected from the review of verified journals. It will generate in-depth knowledge regarding the facilitators and barriers for the visible persons to access the health care facilities. The effective use of Cross-sectional study will also ensure the actual study findings in the identification of the real barriers in the Healthcare industry of Australia. It is important to note that the selected tools will generate efficient knowledge along with offering potential information from the verified papers which will aid in the works of the reviewers.

Data extraction

The process of data extraction in the research for the barriers and facilitators of the disabled person to access the health care service is mainly conducted to maintain consistency. According to Mathes, Klaßen & Pieper (2017), data extraction is mainly referred to as the procedure of increasing all the prime characteristics of the study in a standardised and structured approach on the basis of the data collected from journal articles and different papers. The qualitative data from the different journal articles will be extracted by the reviewer. They will utilise the data extraction tool in the research and the outcomes will also be cross-checked for finding any varieties. The outcomes will be clarified and discussed in a thorough manner to enter the summary of the extracted data (Davidsson & Södergård, 2016). In this regard, the researcher will utilise the effective tool for identifying the facilitators and barriers which are restricting or ease the disabled person to access the health care service across Australia. The facilitators will also be summarised in three different steps for the better clarification of the noted information. The initial step is to gain entry into the healthcare system and then to access the location along with finally figuring out the appropriate Health care providers. The findings of the study will also suggest the 7 different categories of the facilitators and barriers including the financial resources and the insurance coverage. It will also be effective to identify the actual resources on the financial aspect by critically analysing the data along with extracting the inefficient information. 

The verboten extraction for the findings will help the researcher to analytically interpret the main themes and the relatable illustrations will provide convenient observations from the potential journal articles. It will be beneficial for the researcher who will be the gainer by providing consistency within a systematic review. It is important to note that the information, while obtained from the unpublished articles, is included in the methodological evaluation of the entire study. For that reason, data extraction is mainly carried out. As argued by Feldman et al. (2019), the standardized process of data extraction mainly decreases the potential by improving the reliability and validity of the entire study. The major inclusion for data extraction within a systematic review is properly defining the main research question along with developing eligibility criteria for the engaging studies. It will also search out the studies which mainly indicate the research questions and then it will consider the papers which will properly meet the eligibility criteria for inclusion in the systematic review (Edwards, Sakellariou & Anstey, 2020). Therefore, the disabled patients who are not assessing the health care service due to different barriers will be easily identified through data extraction as it helps to obtain data from different databases. The systematic review helps to engage data extraction by which it can properly remove the duplicate citations for the existing research papers along with storing the discarded references. Finally, detection will help to conduct the systematic review in a specific way by which the reviewer can easily work with a vast range of data. 

Data synthesis

The process of data synthesis is mainly focused on the evolution and combination of the extracted data from the findings of the specific papers. In this particular regarding the barriers and facilitators for assessing the health care service to the disabled person, the qualitative findings of the research will be engaged for an outlined method by which the actual information from the Healthcare system will be retrieved by the qualitative systematic review (Gibson & O’Connor, 2010). It will be beneficial for the researchers because the findings will help the study to be influenced by affective factors that are specifically creating barriers for disabled patients in the Healthcare industry. According to Rees et al. (2020), the disability not only engages the different body parts or organs but also involves improper facilities from the Medicare organisations. The synthesis of the data will analyse the actual reason for the barriers along with interchanging the aspects which help the facilitators to mitigate the barriers. The data synthesis will explain the actual challenges experienced by disabled people in moving from one area to another. It also creates a critical barrier to receiving health care services. 

Effective utilisation of data synthesis will generate potential knowledge by which the critical barrier can be washed out and the Australian government can identify the way in which they can provide health to access the Medicare and Healthcare service for the disabled people. As explained by , the data synthesis will also identify the external influencing factors by evaluating different articles and literature by which the actual convenience of infrastructure and the potential meaning of accessibility and transportation will be perceived by the government. The process of data synthesis has major importance in a systematic review by which it provides the major focus to recognise analyses as well as summarise the findings from the relatable studies in a specific health issue. In this systematic review, the data synthesis will recognise major areas and facilitators along with evaluating their cruciality by which the summarised findings will help to provide an in-depth solution for the government regarding the accessibility of healthcare for the disabled person. As described by Gillis et al. (2019), It will not only provide the convenience of evidence but also engage more accessibility for the decision-makers, specifically the researcher, to establish the main motive of the study. It will help to provide effective recognition of the facilitators along with identifying the factors which will mitigate the barriers for the disabled person by which they can access the Healthcare facilities. 

Conclusion

The execution of a qualitative study is based on the qualitative findings added to the data pool while following a systematic review. The study regarding facilitators and barriers having an influence over the access of healthcare service among disabled people is based on the qualitative study while following a set of exclusion and inclusion criteria and search strategies. The keywords need to be identified, which would help in starting the search in the database while maintaining a continuous focus on the requirement of the study. An authentic database such as PubMed would be considered for retrieving data and systems such as endnote would be used to remove duplicate data. 

References 

Davidsson, N., & Södergård, B. (2016). Access to healthcare among people with physical disabilities in rural Louisiana. Social work in public health, 31(3), 188-195. https://doi.org/10.1080/19371918.2015.109949

Edwards, D. J., Sakellariou, D., & Anstey, S. (2020). Barriers to, and facilitators of, access to cancer services and experiences of cancer care for adults with a physical disability: A mixed methods systematic review. Disability and health journal, 13(1), 100844. https://doi.org/10.1016/j.dhjo.2019.100844

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), 420. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148624/

Feldman, S., Ammar, W., Lo, K., Trepman, E., van Zuylen, M., & Etzioni, O. (2019). Quantifying sex bias in clinical studies at scale with automated data extraction. JAMA network open, 2(7), e196700-e196700. doi:10.1001/jamanetworkopen.2019.6700 

Gibson, J., & O’Connor, R. (2010). Access to health care for disabled people: a systematic review. Social care and Neurodisability. https://doi.org/10.5042/scn.2010.0599

Gillis, C., Mirzaei, F., Potashman, M., Ikram, M. A., & Maserejian, N. (2019). The incidence of mild cognitive impairment: A systematic review and data synthesis. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 11, 248-256. https://doi.org/10.1016/j.dadm.2019.01.004

Hosain, G. M., & Chatterjee, N. (1998). Health-care utilization by disabled persons: a survey in rural Bangladesh. Disability and rehabilitation, 20(9), 337-345. https://doi.org/10.3109/09638289809166091

Joda, T., Zarone, F., & Ferrari, M. (2017). The complete digital workflow in fixed prosthodontics: a systematic review. BMC Oral Health, 17(1), 1-9. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-017-0415-0

Jung, R. G., Di Santo, P., Clifford, C., Prosperi-Porta, G., Skanes, S., Hung, A., ... & Hibbert, B. (2021). Methodological quality of COVID-19 clinical research. Nature communications, 12(1), 1-10. https://doi.org/10.1038/s41467-021-21220-5

Ma, L. L., Wang, Y. Y., Yang, Z. H., Huang, D., Weng, H., & Zeng, X. T. (2020). Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?. Healthcare assignment Military Medical Research, 7(1), 1-11. https://doi.org/10.1186/s40779-020-00238-8

Mathes, T., Klaßen, P., & Pieper, D. (2017). Frequency of data extraction errors and methods to increase data extraction quality: a methodological review. BMC medical research methodology, 17(1), 1-8. https://doi.org/10.1186/s12874-017-0431-4

Patino, C. M., & Ferreira, J. C. (2018). Inclusion and exclusion criteria in research studies: definitions and why they matter. Jornal Brasileiro de Pneumologia, 44, 84-84. https://www.scielo.br/j/jbpneu/a/LV6rLNpPZsVFZ7mBqnzjkXD/?format=html&lang=en

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Appendix 1: Search strategy