在艾滋病毒护理的背景下,系统性不平等,尊严和信任:定性分析
Amanda L Sanchez1, Chynna Mills2,3, DeAuj'Zhane Coley4
1Department of Psychology, George Mason University, Fairfax, VA, USA. asanch49@gmu.edu.
International journal for equity in health
|May 6, 2025
概括
社区卫生工作者可以通过管理问题解决 (MAPS+) 来提高艾滋病毒护理的坚持和保留. 解决系统性不平等和结构性压迫对于公平的艾滋病毒治疗和实现健康平等至关重要.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 艾滋病毒/艾滋病研究研究
背景情况:
- 坚持和留在护理中对于艾滋病毒感染者的积极健康结果至关重要.
- 由于结构性压迫,边缘化社区在艾滋病毒护理方面面临重大挑战.
- 像Managed Problem Solving (MAPS+) 这样的社区卫生工作者 (CHW) 干预有希望,但需要了解系统性障碍.
研究的目的:
- 探索影响艾滋病毒护理坚持和保留的系统性不平等.
- 确定解决艾滋病毒护理中的这些挑战的方法.
- 了解像MAPS+这样的干预措施是如何公平地实施的.
主要方法:
- 与13家诊所和4个组成组 (临床医生,辅助人员,管理人员,决策者) 进行了半结构化访谈.
- 在建构主义范式中采用反射的主题分析.
- 专注于理解系统不平等的经验和应对策略.
主要成果:
- 确定了与MAPS+相关的系统不平等,包括资源获取,医疗护理导航,权力动态,医疗不信任,耻辱和患者负担.
- 突出了工作人员和临床医生如何建立信任和中心患者需求,MAPS+可能支持这一点.
- 承认医疗保健工作人员承担的负担是解决现有系统中的不平等问题.
结论:
- 个人和组织的努力是不够的;结构性变化是必要的,以解决艾滋病毒护理的系统不平等.
- 结束艾滋病毒流行需要全面的战略,直接面对结构性压迫.
- 实现艾滋病毒感染者的健康公平需要解决结构因素和医疗保健获取之间的复杂相互作用.
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