美国原住民和第一民族人群的整形和重建手术的差异和护理障碍
Forrest Bohler1, Madeline N Pham2, Tamara Attisha3
1From the Oakland University William Beaumont School of Medicine, Rochester, MI.
土著人口经历了显著的健康差异,面临的障碍,塑性和重建性手术 (PRS) 访问. 解决这些问题需要改善基础设施,对文化敏感的护理,以及在PRS中增加土著代表.
科学领域:
- 健康 公平 卫生 公平
- 外科手术的准入.
- 土著健康土著健康
背景情况:
- 美国印第安人,阿拉斯加原住民和第一民族人口面临着记录的健康差异.
- 在这些社区的塑性和重建性手术 (PRS) 获取中存在着未被充分认识到的不平等.
- 较高的PRS相关条件负担 (裂,创伤,烧伤,瘤后缺陷),但服务利用率较低.
研究的目的:
- 综合有关美国和加拿大的土著人口在PRS获取差异的文献.
- 确定疾病的流行率,护理障碍,以及改善获得医疗服务的策略.
- 审查同行评审的文章和政策来源,寻找反复出现的主题和解决方案.
主要方法:
- 现有文学作品的叙事综合.
- 专注于疾病的流行,接入障碍和建议的解决方案.
- 审查同行评审的文章和政策文件.
主要成果:
- 显著的障碍包括地理隔离,资金不足的服务 (如印度卫生服务),供应商短缺,社会经济困难和文化不信任.
- 建议的解决方案:扩大远程医疗,建立外展计划,培训当地提供者,加强合作伙伴关系.
- 强调在医疗保健中增加土著代表和部落自决权.
结论:
- 解决PRS差异需要多方面的努力:即时访问改进和长期投资.
- 专注于劳动力发展,基础设施和文化调整的护理.
- 学术项目,政策制定者和土著社区之间的协调对于手术公平至关重要.
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