一种隐形标准化患者方法来测量和减少交叉医疗保健耻辱感
medRxiv : the preprint server for health sciences
|September 4, 2023
概括
这项试点研究表明,对医疗保健提供者来说,减少耻辱的培训是可行的和可以接受的. 该干预措施对与男性发生性关系的男性的护理产生了初步积极影响,但对艾滋病毒感染者需要进一步的临床内容.
科学领域:
- 医疗保健的获取和质量
- 公共卫生干预措施 公共卫生干预措施
- 耻辱的减少策略的减少策略.
背景情况:
- 耻辱严重影响艾滋病毒感染者 (PLWH),与男性发生性关系的男性 (MSM) 和身份交叉的个人获得医疗保健.
- 采用一种新的隐形标准化患者 (SP) 方法,收集提供者的观察结果,以开发有针对性的耻辱减轻培训.
- 该研究评估了旨在减轻艾滋病毒污名,反同性恋污名和交叉污名的干预措施的可行性,可接受性和初步影响.
研究的目的:
- 评估医疗保健提供者新型耻辱减轻培训的可行性和可接受性.
- 评估干预对不同患者群体医疗保健质量的初步影响.
- 在医疗保健环境中,为制定文化上适当和有效的耻辱减轻策略提供信息.
主要方法:
- 干预方案的设计是基于基线的隐形医生访问,评估不同艾滋病毒状况和性取向情景的护理质量.
- 培训模块包括教学,体验和基于讨论的组件.
- 后续一轮的SP访问和线性固定效应回归模型被用于评估培训的影响.
主要成果:
- 试点RCT的可行性和可接受性很高,在55名参与者中,招聘率为87.3%,访问完成率为74.5%.
- 参与者发现培训内容非常有用.
- 初步效应表明,对HIV阴性MSM的HIV检测和对HIV阳性MSM的诊断工作有积极的影响,尽管统计准确性有限.
结论:
- 试点RCT成功地证明了医疗保健污名化减少干预措施在低收入/中等收入国家中的可行性,可接受性和一些影响.
- 干预对PLWH护理结果的影响有限,这表明未来培训模块需要增强临床内容.
- 未来的代应该专注于提高提供者的信心和技能,以尊重和安全地管理艾滋病毒患者.
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