确定第一民族人面临下肢截肢风险的预防护理障碍:一项定性研究
Tyrell Wees1, Mamata Pandey1, Susanne Nicolay1
1College of Medicine (Wees, Kopriva), University of Saskatchewan; Research (Pandey), Saskatchewan Health Authority; Wellness Wheel Medical Clinic (Nicolay), Regina, Sask.; Muskowekwan First Nation (Windigo), Lestock, Sask.; George Gordon First Nation (Bitternose), Regina, Sask.
CMAJ open
|October 10, 2023
概括
医疗保健获取障碍导致治疗延迟,并在需要下肢截肢护理的第一民族人群中造成更糟糕的结果. 改善的伙伴关系和文化能力的护理对于公平的医疗服务至关重要.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 土著健康土著健康
背景情况:
- 加拿大的第一民族人经历了较高的非创伤性下肢截肢率.
- 与非第一民族个人相比,他们往往更年轻,存在糖尿病足部感染,并且缺乏先前的再血管化.
- 这项研究旨在确定高风险的第一民族人群的医疗保健准入障碍和患者体验.
研究的目的:
- 识别对有风险的或经历过非创伤性下肢截肢的第一民族患者获得医疗保健的障碍.
- 探索这些患者在医疗保健系统中的经历.
- 确定改善护理和结果的潜在解决方案.
主要方法:
- 社区参与式研究设计,涉及两个社区的代表.
- 用有目的的抽样进行解剖现象学方法.
- 在2021年8月至12月期间,与医疗保健团队和患者进行了五个半结构化的焦点小组.
主要成果:
- 医疗保健接入障碍导致护理延迟,并发症增加,截肢风险更高.
- 在城市中心的负面经验和积极的程序导致不信任,脱离,和糟糕的健康结果.
- 患者和医疗服务提供者建议加强城乡伙伴关系,加强教育和创新的健康战略.
结论:
- 系统性变化,健康促进计划和可靠的储备区初级保健对公平获取至关重要.
- 通过加强城市和社区提供者之间的伙伴关系和沟通,可以实现更好的医疗保健服务.
- 城市卫生保健提供者继续教育和文化能力培训对于更好的结果至关重要.
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