Holistic Health Care Research Articles

Assessment of patient’s perception and knowledge towards anesthesia services at Dilla University Referral Hospital, South Ethiopia, 2021: a cross-sectional study

Background: The poor community understanding of anesthesia professionals and their discipline has been a long-standing and obvious problem. Many studies have been done in the developed countries investigating public awareness of anesthetists but there are few publications from the developing countries including Ethiopia. Patients’ knowledge of anesthetists and their roles inside and outside the operation theatre is poor worldwide. Objective: This study is aimed to assess patients’ perception and knowledge of anesthesia service among patients admitted for surgery at Dilla University Referral Hospital (DURH), Southern Ethiopia, 2021. Methods: An institutional-based cross-sectional questionnaire survey was carried out on consecutive adult patients aged 18 years and above that had undergone surgery at DURH, conducted over four months. Data were presented using tables, and graphs and summarized by using dummy tables. After carefully analyzing the collected data, a conclusion was made with constructive recommendations. Result: A total of 396 patients were initially included in the study while 27 patients declined to participate with a 93% response rate. The mean age of participants was 39.5±14.9 years, and more than half of the respondents 225 (61%) were male. Regarding the type of surgery done 238 (64.6%) respondents were emergency the rest of 35.4% were elective surgery. Of 369 respondents, only 42% knew that anesthetist is the one who gives anesthesia and 38% knew that a doctor does. Conclusion: The perception of most patients is that anesthesia is all about “putting patients to sleep and waking them up.” There was poor knowledge of patients regarding the role of anesthetists beyond the confines of the operating theater. Therefore, there is a need for intensified public education on the importance of anesthesia and the diverse roles anesthetists play in ensuring holistic health care delivery.

"It's Not Just a Plaster Cast, My Leg Is in It!": Patient Experiences: A Qualitative Study.

Plaster casts have been used in the treatment of fractures since 1850, and they play an important role in the healing of extremity injuries and operative repairs. Despite the high incidence of fractures and the widespread use of plaster casts in patients with fractures, the quality of counseling in patients with plaster casts has been neglected. There are few studies on the quality of this patient advisement and the nonmedical experiences of patients with plaster casts. We believe that understanding the feelings, thoughts, and experiences of patients who have had plaster casts will contribute to holistic patient care and will guide the planning of such care. The aim of this study was to describe some of the nonmedical experiences of being in a plaster cast and to illustrate these difficulties through patient quotes. This qualitative research study used a qualitative, descriptive approach guided by phenomenology to explore and describe the subjective experiences of patients with plaster casts. Participants consisted of 10 patients with lower extremity fractures, all of whom had been in a plaster cast for at least 6 weeks. Data were collected through in-depth individual interviews using semistructured questionnaires. The content analysis method was used to analyze the data. COREQ (Consolidated Criteria for Reporting Qualitative Research) was used in structuring and reporting the study. Six themes that described the experiences of patients with a plaster cast were determined in the study. These themes were the basic physiological and functional concern, self-image challenges, social roles, dependence/independence, emotions, and the experience of being in a plaster cast. We determined that many aspects of the lives of patients had been affected by being in a plaster cast and that they had experienced not only physiological issues but also psychological, social, emotional, and aesthetic issues. In addition, all the participants stated that they sought solutions to these issues by requesting support from a person or persons around them. Understanding the experiences of individuals with a plaster cast will contribute to the holistic healthcare of individuals who suffer fractures, allowing it to be more patient-centered. This understanding will also support the planning and implementation of patient-centered counseling and education.

An exploration of women's sexual and reproductive health following traumatic brain injury.

To develop a gendered understanding of sexual and reproductive health for Australian women following traumatic brain injury. The intersection of socialised normative expectations of sexuality and sexual health, and being a woman with a disability, can lead to inequity and a misconception that a woman with a disability is asexual. An equal weighting concurrent mixed methods design. Twenty women participated in conversational interviews and 49 women completed an online survey. Equal priority was given to both qualitative and quantitative data which were collected concurrently. A separate analysis of data was performed and was later merged. This paper follows the Good Reporting of a Mixed Methods Study guidelines for reporting mixed methods research. Women reported changes in menstruation, reproduction, and sexual activity. Results identified that following traumatic brain injury, routine reproductive, and sexual health screening were neglected. Women revealed a personal reticence to discuss sexual health in a holistic sense and appeared more comfortable discussing reproductive health rather than sex for pleasure. Additionally, they perceived there was a reticence by clinicians to discuss sexual health as part of their rehabilitation. Shifting the focus to be on women's health through periodic comprehensive health assessments is essential to the delivery of holistic health care. These results can inform the provision of sexual health, sexual safety, and sexual assertiveness education and training for women and girls within a rehabilitation framework and would be a way of addressing what women in this study identified as an unmet need. Reproductive and sexual health are important elements of routine comprehensive health screening for women. Nurses are well positioned to begin discussions regarding sexual agency, sexual, and reproductive health to ensure person-centred care.

Caregiving burden and social support in family caregivers of patients with cancer: A cross-sectional study

Introduction Providing care for patients by family caregivers causes in several consequences known as “Caregiving Burden”, which affects the caregiver's health and the whole family process, considered in holistic healthcare/nursing. This study aimed to evaluate the caregiving burden and social support in family caregivers of patients with cancer and their influencing factors in a local area in Iran. Methods In this cross-sectional study, 190 family members of patients with cancer were studied through convenient sampling method. Data were collected using demographic data sheet enriched with Karnofsky Performance Status Scale and Katz Index of Independence in Activities of Daily Living (ADL), and Zarit Burden Inventory and Medical Outcomes Social Support Survey questionnaires. Results The results indicated intermediate performance status and moderate independence in ADL in patients. The mean score of caregiving burden was 43.95 ± 17.48 which indicates moderate to severe burden. The average social support in the caregivers was 60.25 ± 23.81% which shows above the average social support. Both performance status and dependence in ADL of patient had statistically significant effect on the caregiving burden in caregivers. Also a statistically significant negative relationship was observed between caregiving burden and social support in primary family caregivers of patients with cancer. Discussion Considering the increasing importance of primary care provided by families, developing strategies for providing caregiver's needs through family care in cancer nursing is essential. So supporting caregivers through family nursing in holistic healthcare by providing social support, can play a significant role in reducing caregiving burden in healthcare services considering the qualified holistic healthcare/nursing.

Nutrition Assessment in Student-Run Clinics Serving Hispanic/Latinx Patients

Background: The patients of student-run clinics, especially Hispanic/Latinx patients, are at a disproportionately high risk for chronic disease due to the negative impacts of the social determinants of health, including barriers to obtaining healthcare, ranging from lack of financial resources to fear of deportation. Nutrition services are pivotal in providing effective, holistic healthcare for this patient population seeking care at student-run clinics. The purpose of this review is to examine how nutrition assessment is conducted at student-run clinics and to determine if the nutrition assessments are culturally tailored.
 Methods: Three scientific databases were searched using keywords focused on the concept of nutrition assessment in student-run clinics serving the Hispanic/Latinx population. The articles generated were reviewed by 4 independent reviewers to determine key elements related to nutrition assessment and/or nutrition services provided in student-run, free, or community clinics, with attention to addressing social and cultural barriers addressed by the clinic.
 Results: A search of the literature related to nutrition services at student-run clinics yielded 3 results for nutrition assessment of the Hispanic/Latinx population in student-run, free, or community clinics. Several articles presented research on health behavioral counseling and food insecurity screening, but few studies were conducted specifically on nutrition assessment, especially for the Hispanic/Latinx population.
 Conclusions: The current assessment tools have widespread use in nutrition assessment; however, they are insufficient for the distinctive characteristics of the Hispanic or Latinx population being served in a student-run clinic. Including dietetics students into a student-run clinic, if plausible, and/or a culturally sensitive guided nutrition assessment tool for students would be of benefit to adequately address the relevant social determinants of health in the nutrition assessment of patients at student-run clinics.

The angels and heroes of health care: Justified and appropriate, or harmful and destructive?

The angels and heroes of health care: Justified and appropriate, or harmful and destructive?

Determinants of nutritional status among scheduled tribe women in India

Objective: This research aimed to learn how various socio-demographic factors are associated with nutritional status among Indian Scheduled Tribe reproductive women. Moreover, to understand the spatial variation of Nutritional status among Scheduled tribe women in the current scenario.Methods: The study shows the distribution of underweight, normal, overweight and obese Scheduled Tribe women in India from the National Family Health Survey (NFHS-5), including 1,66,172 women from Schedule tribes reproductive age group. The multinomial logistic regression model was used to analyse how different background factors are associated with BMI.Results: The study observed that among tribal women, 17.4% are underweight, 13.2% overweight, and 2.97% obese. Approximately one-third of the tribal women in the reproductive age group have normal BMI. The age group 15–24 has the highest percentage of underweight, whereas the age group 35 and beyond has the highest prevalence of overweight and obesity.Most of the socio-demographic factors are associated with nutritional level among Scheduled tribe women; The wealth quantile shows the maximum impact on nutritional health among Scheduled tribe women.Conclusion: Scheduled Tribe people are one of the most vulnerable groups in India. As a result, this population is at high risk in practically every health parameter. They continue to depend heavily on subsistence farming for income and survival. The findings provide further evidence that the religion, place of residence, wealth status, age group, education, marital status, parity and family size are some important determinants that are directly associated with nutritional status among tribal women in India. History of neglect and discrimination concerning economic distribution and social status. It is necessary to concentrate on improving regional and community-based development methods and planning and executing appropriate techniques to promote holistic healthcare practices for all.

Australian Patient Preferences for the Introduction of Spirituality into their Healthcare Journey: A Mixed Methods Study

While patients value engagement concerning their spirituality as a part of holistic healthcare, there is little evidence regarding the preferred way to engage in discussions about spirituality. This study investigated inpatient preferences regarding how they would like spirituality to be raised in the hospital setting. A cross-sectional survey was conducted with inpatients at six hospitals in Sydney, Australia (n = 897), with a subset invited to participate in qualitative interviews (n = 41). There was high approval for all proposed spiritual history prompts (94.0–99.8%). In interviews, the context dictated the appropriateness of discussions. Findings indicated a high level of patient acceptability for discussing spirituality in healthcare. Further research and more detailed analysis is required and proposed to be undertaken.

A global grounded theory exploration of investigators’ perspectives on male hormonal contraceptive development and acceptability

ABSTRACT While best practices have been proposed on how to engage men in family planning (FP), the limited options of male hormonal contraceptives (MHC) are a barrier to reaching men as clients of FP programs. The lack of alternative MHC is preventing the global health community from providing holistic reproductive healthcare. A qualitative grounded theory study was conducted in 2020 to explore MHC experts’ perceptions around the development and theoretical acceptability of MHCs. Individual in-depth interviews were conducted with 15 key informants. The informants cited evidence that there is a demand for MHC. The inability to access this data by the pharmaceutical industry was acknowledged. Many informants expressed concern of the possibility for MHC to increase male power in a predominantly patriarchal world. To most informants, at least for the initial introduction of MHC, fertility sharing is something that will largely happen among couples alone rather than individually. There is proven demand among women and men for MHC, however industries may still be reluctant to invest. Effort is needed by the sexual and reproductive health and rights community to include male engagement in FP and to advocate for the development and use of MHC as a tool for women’s empowerment.

Has the COVID-19 pandemic affected the psychological state of arab cancer patients?

The Covid-19 pandemic has increased the vulnerability of cancer patients to psychological symptoms, in addition to treatment modality issues. The present study has aimed to determine the psychological state of Arab cancer patients during the COVID-19 pandemic and to explore the contributing factors. A cross-sectional, descriptive, correlational design with the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Functional Assessment of Cancer Therapy–Fatigue subscale (FACT-F), and the Functional Assessment of Cancer Therapy–General (FACT-G) were used to collect the data. Out of 291 participants, 60.5% were female; 22.7% were 51–60 years; 31.6% were diagnosed with breast cancer; 44.3% with stage 2 cancer; 23% had contracted COVID-19; and 43.3% had received their first dose of the vaccine. The main study findings are: 74.9% had anxiety, 64.3% experienced depression, 68% suffered from insomnia, and 69.8% had fatigue. Quality of life (QoL) was low among cancer patients who had marked anxiety, depression, insomnia, or fatigue, and these findings were statistically significant (p < 0.05). Predictive factors showed males were 5.09 times more likely to report depression; gynecological cancer patients were 40.4 times more likely to experience insomnia, and patients who had COVID-19 were 5.13 times more likely to report fatigue. The study findings reveal that the COVID-19 pandemic affected the psychological state of cancer patients and had a significant effect on their quality of life. Hence, there is a need to develop a holistic cancer health care approach, which is often limited in Arab countries, to help patients manage these symptoms effectively and to decrease the prevalence of mental health morbidity.

Assessment of final-year medical students' entrustable professional activities after education on an interprofessional training ward: Acase-control study.

IntroductionInterprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students’ competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies.MethodsIn March 2021, 32 final-year students, 16 with (ITW group) and 16 without (control group) a previous four-week placement on an ITW participated in a training simulating the first day of residency. The simulated patients assessed students’ communication and interpersonal skills for history taking with the ComCare index after every consultation. Twelve prospective EPAs were assessed by three senior physicians after watching videos of the students’ case presentations.ResultsWhile baseline characteristics and ComCare index ratings were not significantly different between the two groups, the overall mean entrustment level for the 12 EPAs was significantly higher (p < 0.001) in the ITW group compared to the control group (median = 3.15 versus 2.22). The interrater reliability for all EPAs was high and entrustment in students from the ITW group was significantly higher in 10 out of 12 EPAs.DiscussionITW training seems to prepare medical students well to practice competencies which are relevant for prospective entrustment decisions and can be deduced by senior physicians from case presentations. Further studies with larger student cohorts are needed to corroborate this finding and observable EPAs could also be defined to assess students’ competencies after ITW training.Electronic supplementary materialThe online version of this article (10.1007/s40037-022-00720-0) contains supplementary material, which is available to authorized users.

Multimorbidity and multi-disability among the elderly in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60–108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8–40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2–26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.

Collaborative clinical reasoning learning using an integrated care pathway in undergraduate interprofessional education: An explorative study

ABSTRACT Collaborative clinical reasoning (CCR) is part of interprofessional collaborative practice and aims to negotiate and manage patient problems. An integrated care pathway (ICP) can be used as a framework for developing comprehensive patient care, typically in a clinical setting. This study aims to explore the CCR process in undergraduate interprofessional teams and the use of ICP as guidance in discussing a patient’s problem and its comprehensive management. This is a qualitative study following phenomenology and was performed in an interprofessional education (IPE) program held by Health Science Cluster Universitas Indonesia. A total of four observations involving 40 students and four focus-group discussions involving 18 students from different health professions backgrounds were conducted to explore the CCR process using the ICP framework. In-depth interviews with four tutors from different health professions backgrounds and document analysis were also conducted as triangulation processes. This study shows that CCR was held in two stages – individual and group. The ICP framework could be used as a guiding tool in the CCR process to discuss the patient’s management and discharge plan. This study also demonstrates that there are several challenges in this learning process, including the clinical case used in the discussion, the need for prior knowledge and previous exposure to IPE and the ICP framework, and health professions’ dominance during the discussion. This study provides evidence on learning of CCR using the ICP framework as a guiding tool in a pre-licensure IPE program. This approach is useful for preparing students to develop an interprofessional, comprehensive, and holistic health care plan and to help them understand the roles of each profession.

Gender and Health in Healthcare Venues

&lt;p&gt;臺灣醫療場域因應2005年推動性別主流化之國家政策，亦適時調整相關各項醫療規定及推行健康促進政策，如「醫師執業登記及繼續教育辦法」第8條中，規定醫師每6年換照時應完成繼續教育，課程內容包括醫學倫理、醫療法規等，還包括「性別議題」之課程。學習性別教育對於醫療照護場域的益處究竟為何？&lt;/p&gt; &lt;p&gt;本文將探討性別主流化政策進入醫療領域後對病人健康照護之幫助、過去醫療場域可能造成之性別偏見與治療影響，以及看見醫療環境下之性別差異。醫事人員繼續教育課程納入性別議題，可提升性別敏感度、性別意識，以達到全人醫療、全人照護的最終目標。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;In response to Taiwan’s promotion of the national gender mainstreaming policies in 2005, relevant regulations in healthcare venues have been adjusted, and health promotion policies have been implemented promptly. According to Article 8 of the Guidelines for the Licensing and Continuing Education of Physicians, physicians are required to complete their continuing education when they renew their licenses every 6 years. This education should cover subjects on medical ethics, medical regulations, and gender issues. Debates have emerged regarding the benefits of gender education to healthcare practice.&lt;/p&gt; &lt;p&gt;This study explored how the implementation of gender mainstreaming policies in healthcare venues benefits patient care; examined the effect of gender discrimination on healthcare treatment before policy implementation; depicted gender differences in the healthcare environment. Incorporating gender issues into continuing education received by healthcare professionals raises their gender sensitivity and awareness, helping them provide holistic health care.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Impact of multimorbidity and complex multimorbidity on mortality among older Australians aged 45 years and over: a large population-based record linkage study

ObjectivesMultimorbidity (MM, co-occurrence of two or more chronic conditions) and complex multimorbidity (CMM, three or more chronic conditions affecting three or more different body systems) are used in the assessment...

Speech-language Pathologist: A Team Member for Management of Head and Neck Cancer Patients

Head and Neck cancer is one of the most prevalent conditions in the world and so is in Nepal. Head and Neck cancer causes speech, language, and swallowing disorder that affects the quality of life of a patient. A multidisciplinary team is needed for the management of the cancer patient. A Speech Language Pathologist is one important team member involved in the rehabilitation of communication and swallowing issues. The role of Speech Language pathologists should be understood by other medical professionals and need to be integrated into the team to provide a holistic health care facility to an individual with head and cancer.

Attitudes and Perceptions Regarding Sexual Health History Taking; A Cross-Sectional Study Among Undergraduate Medical Students of College of Medicine and Health Sciences, Oman

Background: Sexual health has been recognised as an essential dimension of health. Therefore, sexual health training of health care providers assumes a significant role. The present study was conducted to assess the attitudes and perceptions of final-year medical students regarding sexual health history taking at a medical college in Oman. Methods: The present cross-sectional survey was conducted among 81 final-year medical students. Demographic characteristics, attitudes and perceptions of the participants regarding sexual health history taking were collected using a self-administered questionnaire after obtaining informed consent. Prior approval was obtained from the institutional research and ethics committee. Statistical analysis was conducted using SPSS 20.0 Results: The mean age of the participants was 24.19 ± 1.03 years. Most of the participants (97.6%) opined that it was important for doctors to know how to elicit a sexual health history. Most of the participants were aware of their limitations in eliciting sexual health history and recognizing gender and cultural differences (67.9%) as barriers while communicating sexual health problems with the patients. About 50%of the participants responded that they had satisfactory understanding of sexual health (50.7%); a similar number had an adequate understanding of sexual health problems (53.1%). Majority (65.4 %) of the participants were interested in learning about sexual health. Conclusion: The present study revealed that medical students recognised the importance of sexual health history taking and their strengths and limitations regarding the same. The study revealed the barriers to effective communication between students and patients in matters of sexual health, which pave the way to improve teaching-learning programs and ultimately contribute to providing effective holistic health care.

Dialysis, Distress, and Difficult Conversations: Living with a Kidney Transplant.

Background: Providing holistic care to kidney patients is important; however, without full consideration of the perspectives of people living with a kidney transplant, the provision of truly ‘holistic healthcare’ cannot be possible. It is imperative to understand patient experiences by including kidney patients in key strategies and future renal service planning. Ignoring these important patient views means that there is a significant risk of inappropriate renal service provision and lack of adequate support, impacting overall health. The aim of this study was to develop an in-depth understanding of the lived experiences of kidney transplant recipients. Methods: A total of 23 participants were recruited between two regional nephrology units within the United Kingdom via clinical gatekeepers. In-depth interviews were undertaken. Interviews were digitally recorded, transcribed verbatim, and subjected to interpretative phenomenological analysis. Results: Two themes emerged: “managing ongoing fears of dialysis, distress, and COVID-19” and “dealing with difficult conversations”. Conclusions: Renal healthcare professionals need to understand more than the biological impact of receiving a kidney transplant. Understanding the holistic and multidomain experiences that these participants experience will help healthcare professionals to recognize the needs of this group and ensure more responsive psychosocial care.

Using Social Prescribing to Practice Social Responsibility: A Case Study in the Taipei Medical University System

The Ministry of Education launched the University Social Responsibility (USR) Program in 2018. Since then, universities have actively promoted inter-disciplinary cooperation and implemented high-end knowledge to meet community needs. Universities are using social responsibility to enhance the level of social participation engaged in by their students to achieve the sustainable development goals set by the United Nations. The aim of this paper was to share the experience of the Taipei Medical University (TMU) system in practicing social responsibility by integrating TMU resources with those of TMU-affiliated hospitals. The USR program at Taipei Medical University promotes the reform of school governance through encouraging university faculties to collaborate with hospital physicians to develop a specific curriculum that implements an innovative social-prescribing model. This curriculum is designed to provide opportunities for students to step out the classroom and into the community. Through clinical observations, home visits, and community service, students gain a deep understanding of community health issues from residents in the surrounding neighborhoods. Medical humanities education is achieved through students' involvement in both patient individual care and community health issues. In addition, faculties guide students in reflective learning from holistic healthcare perspectives. Students are encouraged to use evidence-based methods to develop innovative models of care in the community. Medical staff participation in this program helps ensure that social prescribing to community residents accurately reflects professional assessments. These prescriptions refer patients to local health promotion units involved in community collaboration. The medical university students build a bridge between the medical system and the community to implement the goals of health education. The impact of social prescribing on the social determinants of health is known to be significantly greater than that of medicine prescriptions. The expected outcomes of this project are to reduce the health inequalities experienced by vulnerable groups in the community and to share Taiwan's experiences with the academic community worldwide.

Use of massage therapy by mid-aged and older Australian women

BackgroundMassage is a widely acceptable and popular form of complementary medicine (CM) among Australian women. While there is some research that reports on massage use in younger women, there is minimal research exploring massage use in the treatment of chronic illness in older women. This study provides an estimate of the prevalence of massage use, as well as identifying the characteristics significantly associated with consultation with a massage therapist, for mid-age and older Australian women.MethodsA cross-sectional sub-study was conducted on a sample of women drawn from the 45 and Up Study; a large cohort study of adults aged 45 years and over. Data from 1795 women were included in the analyses and massage use was compared against measures of demographics, health status and health care utilisation.ResultsA total of 174 (7.7%) women consulted with a massage therapist in the previous 12 months. Women were more likely to consult a massage therapist if they have tertiary level education (O.R. = 1.67; 95% C.I.: 1.04, 2.65; p = 0.031), private health insurance (O.R. = 6.37; 95% C.I.: 4.41, 9.19; p < 0.001) and/or osteoarthritis (O.R. = 1.72; 95% C.I.: 1.19, 2.48; p = 0.004). They were also more likely to consult a massage therapist if they have a poorer health-related quality of life (HRQoL) (O.R. = 1.14; 95% C.I.: 1.04, 1.27; p = 0.007).ConclusionOlder, tertiary-level educated Australian women with private health insurance were more likely to use massage therapy, as were women with osteoarthritis specifically. Women with lower HRQoL were found to be more likely to use massage therapy in the treatment of their chronic illness. This research provides insight into the determinants of massage use among ageing women and is useful for governments in consideration of accessibility to holistic healthcare when developing public policy for healthcare in Australia.