针对儿童状细胞疾病疼痛护理中提供者隐性偏见的干预措施的初步评估:混合方法试点研究
Siddika S Mulchan1,2, Christopher B Theriault1, Susan DiVietro1,2,3
1Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
概括
这项研究测试了一项干预措施,以减少医疗保健提供者 (HCP) 对治疗状细胞疾病 (SCD) 的青少年的隐性偏见. 虽然干预是可行的和可接受的,但干预并没有显著减少偏见或改变临床决策.
科学领域:
- 医学教育 医学教育
- 健康差异 在健康上的差异
- 儿科血液学 儿科血液学
背景情况:
- 医疗保健提供者 (HCP) 之间的隐性偏见可能会对患有状细胞病 (SCD) 的儿科患者的健康结果产生负面影响.
- 解决提供者偏见对于改善SCD管理中的公平护理至关重要.
- 以前的干预措施并没有专门针对儿科SCD医疗人员的隐性偏见.
研究的目的:
- 评估个性化和前景化 (IPT) 干预措施的可行性,可接受性和初步影响.
- 该干预旨在减少儿科SCD医疗人员的隐性偏见.
- 评估干预对治疗疼痛的临床决策的影响.
主要方法:
- 一项试点研究采用混合方法方法,将36名医疗保健人员随机分配到干预或控制组.
- 在干预前和干预后 (3个月) 收集了隐式和显式偏见指标.
- 临床决策被评估使用虚拟的患者简历;通过焦点小组收集定性数据.
主要成果:
- 随着时间的推移或干预和对照组之间的偏差得分没有观察到统计学上显著的差异.
- 虽然医疗保健专家的评级因提供者类型而异,但干预措施并没有影响基于患者种族或诊断的决定.
- 定性分析显示,医疗保健人员发现干预是可行的,可以接受的,有影响力的,并提出了改进建议.
结论:
- 这是第一个评估儿科SCD医疗人员IPT干预的研究.
- 这项干预被认为是可行的和可接受的,具有潜在的影响.
- 未来的研究应该完善IPT干预,纳入患者参与和技能实践,以改善对这一群体的护理.
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