医疗保健歧视影响了黑人美国人的患者激活,沟通自我效能和疼痛
Veronica Derricks1, Adam T Hirsh1, Anthony J Perkins2
1Department of Psychology, Indiana University Indianapolis, Indianapolis, Indiana.
The journal of pain
|August 30, 2024
概括
在医疗保健中遭受种族歧视的患有慢性疼痛的黑人退伍军人有更糟糕的结果,包括较低的患者激活率和自我有效性. 强大的医生与患者关系并没有减轻这些负面影响,突出显示了需要进行系统性改变的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 慢性疼痛中的心理社会因素
背景情况:
- 医疗保健中的种族歧视是黑人美国人的重要压力因素.
- 了解它对慢性疼痛管理和患者参与的影响对于健康公平至关重要.
研究的目的:
- 检查在医疗保健和患者激活,沟通自我效能和慢性疼痛的黑人退伍军人身体健康结果中感知到的种族歧视之间的关联.
- 探讨医生与患者的工作联盟在缓解这些影响方面所起的调节作用.
主要方法:
- 来自一项临床试验的基线数据的二次分析,该试验涉及250名患有慢性肌肉骨疼痛的黑人退伍军人.
- 从2018年至2021年期间从中西部VA医院的初级保健诊所收集的数据.
主要成果:
- 感知到的种族歧视与较低的患者激活,较低的沟通自我有效性,较高的疼痛强度和较低的疼痛管理自我有效性 (p < .049) 相关.
- 歧视与疼痛干扰或应对策略无关 (p > .157).
- 医生与患者的工作联盟调节了对患者激活的影响,但没有缓冲与感知歧视相关的负面结果.
结论:
- 在医疗保健中感知到的种族歧视与患有慢性疼痛的黑人退伍军人中患者激活和自我有效性有广泛的负面关联.
- 一个强大的医生-病人工作联盟似乎无法减轻被认为是歧视的不利后果.
- 系统层面的干预是必要的,以解决医疗保健机构的种族虐待,以减少健康差异.
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