在出生时的污名化和积极语言与种族和种族相关的临床注意事项
Ismael Ibrahim Hulchafo1, Jihye Kim Scroggins2, Sarah E Harkins1
1Columbia University School of Nursing, New York, New York.
JAMA network open
|May 13, 2025
概括
医院分娩的临床记录显示,在语言使用方面存在种族和民族差异. 黑人患者经历了更多的污名化语言,而西班牙裔患者的语言记录不那么积极,突出了改善沟通实践的需要.
科学领域:
- 医疗信息学 医疗信息学
- 健康差距 研究 研究 研究 研究
- 临床文档分析 临床文档分析
背景情况:
- 临床文档语言可以延续偏见,并导致健康差异.
- 了解患者人口统计和笔记中使用的语言之间的关联对于公平的护理至关重要.
研究的目的:
- 调查患者的种族和种族之间的关系,以及医院分娩入院期间临床笔记中对耻辱和积极语言的记录.
主要方法:
- 一项横截面研究分析了两家美国大都会医院 (2017-2019) 的18646名分娩患者的自由文本临床笔记.
- 使用自然语言处理 (NLP) 来识别污名化语言 (例如,边缘化身份,质疑信誉) 和积极语言 (例如,患者自主权,权力) 的类别.
主要成果:
- 与白人患者相比,黑人患者有更高的被记录的污名化语言 (OR,1.25) 和积极语言 (OR,1.18) 的几率.
- 西班牙裔患者表现出较低的记录积极语言的几率 (OR,0.90).
- 亚洲或太平洋岛屿患者在"权力和/或特权"类别中语言的几率较低 (OR,0.71).
结论:
- 在劳动和分娩临床笔记中,在种族和种族群体之间对耻辱和积极语言的记录中存在显著的差异.
- 调查结果强调了改进文档和沟通策略的必要性,以减轻偏见的语言和促进健康公平.
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