坚持标签:了解"诊断"不坚持的起源,局限性和道德挑战
Sourik Beltrán1,2, Peter F Cronholm3, Stephen J Bartels2
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts SBELTRAN@bidmc.harvard.edu.
Annals of family medicine
|May 27, 2025
概括
患者坚持挑战往往被错误标记,忽视了临床医生的角色和结构障碍. 重构"不坚持"避免了对边缘患者的污名化,并改善了医生与患者的关系.
科学领域:
- 医学社会学 医学社会学
- 健康差距 研究 研究 研究 研究
- 临床沟通研究 临床沟通研究
背景情况:
- 医疗执法在临床实践中仍然是一个持续的挑战.
- 标准模型通常仅将不遵守归因于患者的行为,忽视了上下文因素.
- 现有的术语可以病态化患者,损害医生与患者的关系.
研究的目的:
- 批判性地检查临床医生在患者遵守的概念化中的作用.
- 探索坚持性术语如何作为社会标签,潜在地掩盖护理的结构性障碍.
- 提出一种替代模型,依从性标签,以更好地理解和解决边缘化患者的护理障碍.
主要方法:
- 在临床环境中审查依从性术语的基础逻辑.
- 分析医学研究和实践中不遵守的病理化.
- 作为一个替代框架,坚持标签的概念发展.
主要成果:
- 坚持性术语可以被用作义的社会标签,对患者的感知和护理产生负面影响.
- 专注于患者行为可以将结构性障碍 (例如贫困,种族主义) 重构为个人失败.
- 临床医生对患者遵守的看法,当被标记时,可以无意中阻碍对边缘化群体的护理.
结论:
- 坚持标签的概念为了解术语如何影响患者护理提供了一个新的镜头.
- 超越简单的遵守标签对于公平的医疗保健服务至关重要.
- 解决结构因素和临床医生沟通对于改善患者的治疗结果和减少健康差异至关重要.
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