在ICU家庭会议中探索家庭表达情绪和临床医生同情心的种族差异
Matthew E Modes1, Deborah B Ejem1, Whitney Welsh1
1AFFILIATIONS: From the Division of Pulmonary and Critical Care Medicine (M. E. M.), the Division of General Internal Medicine (T. K. N.), the Biostatistics Shared Resource (S. K.), Cedars-Sinai Medical Center, Los Angeles, CA; the School of Nursing (D. B. E.), University of Alabama at Birmingham, Birmingham, AL; the Social Science Research Institute (W. W., D. P., and J. S.), the Department of Population Health Sciences (K. I. P. and D. C. A.), the Division of Pulmonary and Critical Care Medicine (C. E. C. and D. C. A.), the Division of Geriatrics (K. S. J.), Department of Medicine, the Program to Support People and Enhance Recovery (C. E. C. and D. C. A.), the Duke-Margolis Center for Health Policy (D. C. A.), Duke University; the Cancer Prevention and Control Program (K. I. P.), Duke Cancer Institute; the Geriatrics Research Education and Clinical Center (K. S. J.), Durham Veterans Affairs Healthcare System, Durham; the Division of Pulmonary Diseases and Critical Care Medicine (S. S. C.), Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Pulmonary, Critical Care and Sleep Medicine (E. K. K.), the Cambia Palliative Care Center of Excellence (E. K. K.), University of Washington, Seattle, WA; the Division of Pulmonary, Allergy, and Critical Care Medicine (C. L. H.), Department of Medicine, Oregon Health & Science University, Portland, OR; Program on Ethics and Decision Making in Critical Illness, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center (D. B. W.), and the Department of Critical Care Medicine (D. B. W.), School of Medicine, University of Pittsburgh, Pittsburgh, PA.
在重症监护室 (ICU) 的家庭聚会中存在种族差异. 与白人家庭相比,黑人家庭表达的负面情绪较少,临床医生提供的同情心也较少,这凸显了公平情感支持的需要.
科学领域:
- 关键护理医学 关键护理医学
- 卫生公平性健康公平性
- 关于医疗保健方面的沟通
背景情况:
- 指导方针建议在重症监护机构为家庭提供情感支持.
- 对种族如何影响情绪表达和在家庭聚会期间的支持的理解有限.
研究的目的:
- 根据种族 (黑人与白人) 来调查家庭成员表达情绪的差异和临床医生在ICU家庭会议中的同情提供.
主要方法:
- 针对40个有声记录的ICU家庭会议 (20个与黑人家庭,20个与白人家庭) 的指导内容分析.
- 编码家庭的负面情绪表达和临床医生的同情陈述使用一个既定的方案.
- 由两位分析师独立编码,他们不知道家庭种族,然后进行揭露和比较分析.
主要成果:
- 黑人家庭表达的负面情绪明显少于白人家庭 (中位数为1对4个表达式;P < .001).
- 当消极情绪被表达时,临床医生对黑人家庭 (15%) 和白人家庭 (30%) 的同情反应较少 (P = .099).
- 主持会议的医生主要是白人男性,没有黑人医生被确定.
结论:
- 在ICU家庭会议中,在家庭情绪表达和临床医生的同情心中观察到种族差异.
- 共感沟通需要改进,特别是对于黑人家庭来说,以确保公平的情感支持.
- 干预措施可能是必要的,以加强临床医生提供公平的情感支持.
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