在选修儿科手术咨询期间的父母种族和沟通
Chenery Lowe1,2, Mary Catherine Beach3, Somnath Saha3
1Center for Biomedical Ethics, Stanford University, Stanford, California.
JAMA network open
|November 11, 2025
概括
儿科外科护理中的种族差异与沟通差异有关. 黑人父母的临床医生参与度较低,临床医生占主导地位较高,这凸显了以患者为中心的沟通策略的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科手术 儿科手术
- 卫生传播健康传播
背景情况:
- 边缘化的种族群体,包括儿童和青少年,面临着较差的外科手术结果相比白人同行.
- 临床沟通是儿童手术护理中这些健康差异的一个潜在因素.
研究的目的:
- 调查儿童选择性手术程序的初始咨询期间父母和临床医生之间沟通的种族差异.
- 在儿科外科咨询中确定与种族相关的特定沟通模式.
主要方法:
- 一项队列研究,涉及手术临床医生和接受常见手术的儿童 (2-17岁) 的父母之间的录音咨询.
- 利用罗特互动分析系统量化沟通变量,包括口头主导,以患者为中心和情感陈述.
- 采用通用估计方程来分析父母种族与沟通结果之间的关联,并调整社会人口统计因素.
主要成果:
- 涉及黑人父母的访问显示,与白人父母的访问相比,临床医生的口头主导显著更高,即使在调整后.
- 黑人家长的访问以更少的临床医生聊声明和更低的整体家长参与 (更少的总体陈述,情感陈述和聊) 为特征.
- 虽然患者为中心的得分总体上没有差异,但黑人父母在咨询期间表现出较低的积极影响.
结论:
- 父母种族与临床医生,父母和儿科外科咨询期间的互动沟通的不同模式有关.
- 沟通的差异,特别是父母的参与,可能受到社会人口统计学因素的影响,但也表明需要改进沟通策略.
- 实施以患者为中心的沟通和参与策略对于缓解社会距离和提高儿科外科护理公平性至关重要.
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