障碍和残疾身份以及对信任,尊重和公平的看法
Maggie R Salinger1, Brian Feltz2,3, Stephanie H Chan4,5
1Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.
JAMA health forum
|September 22, 2023
概括
残疾身份,而不仅仅是功能障碍,影响医疗保健经验. 卫生系统应该考虑两者,以减少残疾人的差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康和疾病的社会学
- 健康差异 在健康上的差异
背景情况:
- 大多数研究仅通过功能障碍来定义残疾人.
- 这种方法忽略了那些不认为自己是残疾人的功能障碍患者.
- 在使用基于功能状态的定义时,观察到医疗保健质量的差异.
研究的目的:
- 调查是否损伤和残疾身份与感知到的医疗保健经验有不同的关联.
- 确定与残疾成年人残疾识别相关的因素.
主要方法:
- 在1822名美国成年人中进行了一项横截面调查,使用在线或电话回复.
- 参与者根据缺陷和残疾身份的存在进行了分类.
- 多变量后勤回归分析了损伤,残疾身份和程序正义 (信任,尊重,公平) 之间的关联.
主要成果:
- 有障碍的个人报告说,他们比没有障碍的人更糟糕的程序正义感知.
- 在那些残疾人中,残疾识别与更好的临床医生沟通有关,但感知到的尊重更差.
- 识别残疾与更高的不公平待遇报告和感觉有权质疑提供者相关.
结论:
- 根据功能障碍和残疾身份,人们对医疗保健的看法有很大差异.
- 卫生系统应该在解决护理差异的功能性措施的同时,纳入残疾身份.
- 收入和就业状况与残疾身份识别有关.
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