背景:提供对多样性敏感的护理是减少健康差异的一种有希望的方法。最近的批评和科学差距表明,需要从患者的角度看待多样性敏感的护理。本系统综述旨在描述患者的观点,包括病人的经历,期望,以及对医疗保健提供者提供的多样性敏感护理的满意度。
方法:2022年12月,MedlineALL,Embase,WebofScience核心合集,Cochrane中央控制试验登记册,CINAHL,搜索了PsycINFO和GoogleScholar,以寻找描述或测量患者期望的原始研究,经验,和/或满意度,特别关注医疗保健提供者的文化或多样性能力。使用基于主题综合的会聚混合方法设计对收集的数据进行分析。
结果:从最初的5,387篇文章中,117人被选中进行全文筛选,最终,这项研究包括34篇文章。观察到多样性敏感性护理的概念包括三个组成部分。第一部分侧重于以患者为中心的护理,包括清晰和直接的沟通等能力。共同决策,个性化护理,同理心,和考虑。第二个组成部分的中心是提供文化定制的信息,根据文化需求调整护理,与口译员一起工作,allyship,社区伙伴关系,自我意识,文化知识,并建立在第一个组件上。在多样性敏感护理的前两个组成部分中,患者报告说,他们的医疗保健提供者遇到了不满和缺点,有时会导致与提供者护理有关的第三个也是最后一个组成部分。这一部分强调了语言的重要性,民族,文化,以及在提供优质护理方面的性别一致性。
结论:结论:患者对多样性敏感护理的观点包括多个组成部分,从以患者为中心的护理到和谐护理。这些组件包括各种能力作为沟通技巧,同理心,自我意识和调整照顾文化需求。患者报告说,医疗保健提供者提供的多样性敏感护理的所有组成部分都存在不满和缺点。
BACKGROUND: The provision of diversity-sensitive care is a promising approach towards reducing health disparities. Recent criticism and a scientific gap demonstrate the need for the patient perspective on diversity-sensitive care. This systematic
review aims to describe the patient perspective, including patient experiences, expectations, and satisfaction with diversity-sensitive care provided by healthcare providers.
METHODS: In December 2022 the Medline ALL, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO and additionally Google Scholar were searched for original studies that described or measured patient expectations, experiences, and/or satisfaction, specifically focusing on cultural or diversity competence of healthcare providers. Analysis of the collected data was performed using a convergent mixed-methods design based on thematic synthesis.
RESULTS: From initially 5,387 articles, 117 were selected for full-text screening, and ultimately, 34 articles were included in this study. The concept of diversity-sensitive care was observed to comprise three components. The first component is focused on patient-centered care and includes competencies such as clear and direct communication, shared decision-making, individualized care, empathy, and consideration. The second component centers on providing culturally tailored information, adjusting care to cultural needs, working with interpreters, allyship, community partnerships, self-awareness, and cultural knowledge, and builds upon the first component. Across the first two components of diversity-sensitive care, patients have reported experiencing dissatisfaction and encountering shortcomings in their healthcare providers, sometimes resulting in the third and final component pertaining to provider care. This component underscores the importance of linguistic, ethnic, cultural, and gender concordance in delivering quality care.
CONCLUSIONS: In conclusion, the patient perspective on diversity-sensitive care encompasses multiple components, from patient-centered care to concordant care. The components incorporate various competencies as communication skills, empathy, self-awareness and adjusting care to cultural needs. Patients reported experiencing dissatisfaction and shortcomings across all components of diversity-sensitive care provided by healthcare providers.