社会経済的な要因が,肝硬変患者の医療経験の認識に影響する
Nicole Ng1, Subhanik Purkayastha2, Xiaohan Ying1
1Department of Internal Medicine, NewYork-Presbyterian Hospital/Weill Cornell, New York, NY, USA.
Digestive diseases and sciences
|September 6, 2025
まとめ
肝硬変の患者は医療従事者の経験が異なっており 収入が低いことが コミュニケーションの難しさと関係しています 慢性肝疾患の患者のケアを改善するために これらの格差に対処することが不可欠です
科学分野:
- 医療サービス研究
- 患者 と 医療 提供 者 の コミュニケーション
- 健康 の 格差
背景:
- 患者と医療従事者との良好でない関係が 医療の格差を悪化させています 特にマイノリティー集団や 慢性疾患を患っている人々に影響を与えています
- 医療環境での好ましい相互作用が少なくなれば 患者の治療結果が悪くなり 医療への関与が低下する可能性があります
- 肝硬変の患者は,医療における負の経験のリスクが高い脆弱なグループです.
研究 の 目的:
- 肝硬変と診断された患者の医療提供者との認識と経験を調査する.
- 患者と医療従事者の相互作用の変動に関連する 人口統計的要因,特に所得水準を特定する.
- 慢性肝疾患の管理における患者と医療従事者の関係を改善するための介入の可能性を強調する.
主な方法:
- 全国の代表的な"All of Us"データベースを利用して分析した.
- 主要な成果は"医療における好ましい経験" (医療従事者の尊重,明確性,関与) と定義されています.
- 副次的な結果として"不良な医療経験" (礼儀正しくない,劣悪なサービス,聞かれない) と定義されています.
- 多変数ロジスティック回帰を用いて,関連する共変数を調整して,人口統計学的変数間の経験を比較した.
主要な成果:
- 分析対象は,肝硬変の患者5753人 (平均年齢58,男性51,白人52%).
- 低所得層 (1万~3万ドル,10万ドル未満) は,理解しやすいプロバイダーを見つける確率が著しく低いと報告し,1万5千ドル以上の所得層と比較して,より少ない礼儀性を経験する確率は高い.
- 低所得層は 劣悪なサービスを受ける可能性が 高いのです
- 女性は男性に比べて 聞かれない可能性が高いと報告しています
結論:
- 肝硬変の患者と医療従事者の経験は 社会経済的な地位や性別によって大きく違います
- 低い収入は コミュニケーションの障壁や 尊重の欠如といった 不利な相互作用と強く関連しています
- 患者と医療従事者の関係を強化し,慢性肝疾患の患者との格差を軽減するために,標的を絞った介入が必要である.
さらに関連する動画
12:24A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
5.4K
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
8.4K
関連する概念動画
01:28Esophageal Varices-II: Clinical Features and Management
133
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
133
01:26Diseases of the Liver and Gallbladder
957
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
957
01:25Factors Affecting Perception
1.8K
Perception is influenced by perceptual set, context, motivation, and emotion. Perceptual set, or perceptual expectancy, refers to the tendency to perceive things in a particular way, influenced by previous experiences and expectations. This phenomenon affects the interpretation of stimuli, creating a set of mental tendencies and assumptions that impact sensory perceptions of sound, taste, touch, and sight.
An illustrative example of a perceptual set is the scenario where an airline pilot told...
An illustrative example of a perceptual set is the scenario where an airline pilot told...
1.8K
01:29Issues And Trends In Healthcare Delivery System
5.8K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.8K
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
162
Assessing the gastrointestinal (GI) system is a complex process that begins with collecting subjective data. This data, collected through patient interviews, provides crucial insights into the patient's health history, perception patterns, and lifestyle habits, all contributing significantly to GI health.
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
162
01:21Barriers to Effective Communication II
3.8K
The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
3.8K