Social Justice

社会正义
  • 文章类型: Journal Article
    在单一付款人医疗保健系统中,工作场所正义与非致命职业事故之间的关系很少被探索。随着各国努力实现和维持全民健康覆盖,医护人员的职业安全和健康需要更多的关注。我们使用了对随机抽样的台湾工人进行的全国调查的数据。一百四十八名男性和567名女性,对715名年龄在20至65岁之间的医护人员进行了分析。工作场所规模由4个子部分组成,包括分配正义,人际正义,信息正义,和程序正义,并在每个维度上分为低组和高组。Logistic回归模型研究了工作场所公正与医护人员自我评估的职业事故之间的关系。医护人员自我评估的职业事故发生率为15.54%,男女为11.64%,分别。在调整了诸如社会人口统计学变量之类的变量之后,体力劳动要求,轮班工作状态,工作合同,和心理工作要求,回归分析表明,分配正义较低的卫生员工,人际正义,信息正义,在男性和女性中,程序正义与自我评估的职业事故显着相关。将研究扩展到包括不同国家的医疗保健系统可以增强研究结果的普遍性。为政策制定者和医疗保健管理人员提供具体建议,以改善工作场所的公正性并减少职业事故。
    The relationship between workplace justice and nonfatal occupational accidents in a single-payer healthcare system has rarely been explored. As countries strive to achieve and sustain universal health coverage, healthcare workers\' occupational safety and health require greater concerns. We used the data from a national survey conducted on randomly sampled Taiwanese workers. One hundred forty eight males and 567 females, with a total of 715 healthcare workers aged 20 to 65, were analyzed. The workplace scale consisted of 4 subcomponents, including distributive justice, interpersonal justice, information justice, and procedural justice, and was dichotomized into low and high groups in each dimension. Logistic regression models examined the relationship between workplace justice and self-evaluated occupational accidents among healthcare employees. The prevalence of self-evaluated occupational accidents in healthcare employees was 15.54% and 11.64% for men and women, respectively. After adjusting variables such as sociodemographic variables, physical job demands, shift work status, work contract, and psychological job demands, regression analyses indicated that health employees with lower distributive justice, interpersonal justice, information justice, and procedural justice were significantly associated with self-evaluated occupational accidents both in males and females. Expanding the study to include healthcare systems in different countries could enhance the generalizability of the findings. Offering specific recommendations for policymakers and healthcare administrators to improve workplace justice and reduce occupational accidents.
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  • 文章类型: Journal Article
    受大规模和长期工业污染影响的社区通常渴望了解他们的健康是否因这种污染而受到损害。这需要将环境公共卫生和环境正义观点结合起来的答案。在这些地点,随着时间的推移,多种化学品造成的环境污染的暴露情景,通常涉及不同的环境矩阵,重建是复杂且具有挑战性的。
    提出了一种描述与环境污染相关的此类社区健康的方法,这些方法应用于环境污染的三个领域,人群暴露和毒理学,环境和社会流行病学,和环境公共卫生传播。从应用到托雷斯港的案例研究,都用实例描述了该方法,具有实质性工业条件演变的城镇。
    环境污染领域的活动,人口暴露和毒理学侧重于现有污染数据的收集和系统化,根据其毒理学特征确定优先污染物,对人群暴露于优先污染物的可能性及其已知健康影响的定性评估。环境和社会流行病学方法用于描述当地人口的健康状况和社会经济状况,考虑到来自当地信息系统的多种健康结果,并根据暴露和毒理学评估考虑特定疾病。环境公共卫生沟通方法旨在制定沟通计划,并通过与当地机构和社会行为者的互动来实施。对健康概况的解释得益于对结果的跨学科分析。
    拟议的方法结合了环境公共卫生和环境正义的需求,允许整合多学科知识,以定义减少和/或预防危险环境暴露和不利健康影响的建议。刺激利益相关者之间的互动,使公民更容易获得研究结果。
    UNASSIGNED: Communities affected by large scale and long lasting industrial contamination are often keen to understand whether their health has been impaired by such contamination. This requires answers that integrate environmental public health and environmental justice perspectives. At these sites, exposure scenarios from environmental contamination over time by multiple chemicals, often involving different environmental matrices, are complex and challenging to reconstruct.
    UNASSIGNED: An approach for describing the health of such communities in association with environmental contamination is presented, with the methods applied across the three domains of environmental contamination, population exposure and toxicology, environmental and social epidemiology, and environmental public health communication. The approach is described with examples from its application to the case study of Porto Torres, a town with a substantial industrially conditioned evolution.
    UNASSIGNED: Activities in the field of environmental contamination, population exposure and toxicology focus on the collection and systematization of available contamination data, the identification of priority pollutants based on their toxicological profiles, the qualitative assessment of the likelihood of exposure for the population to priority pollutants and their known health effects. Environmental and social epidemiology methods are applied to describe the health profiles and socioeconomic conditions of the local population, taking into account multiple health outcomes from local information systems and considering specific diseases based on exposure and toxicological assessments. The environmental public health communication methods are directed to produce a communication plan and for its implementation through interaction with local institutional and social actors. The interpretation of health profiles benefits from a transdisciplinary analysis of the results.
    UNASSIGNED: The proposed approach combines the needs of environmental public health and environmental justice allowing the integration of multidisciplinary knowledge to define recommendations for reducing and/or preventing hazardous environmental exposures and adverse health effects, stimulating the interactions between stakeholders, and making the study results more accessible to citizens.
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  • 文章类型: Journal Article
    目的:这项社会法律试点研究的目的是通过识别芬兰癫痫患者的日常问题,深入了解他们诉诸司法的途径。耻辱,偏见及其对癫痫患者生活的影响已广泛记录在文献中。因此,我们还想探讨报告的日常问题和感知的偏见之间是否有联系。
    方法:在研究的第一阶段,在芬兰,法庭案件被用来描述癫痫患者的日常问题。在第二阶段,采用描述性统计方法对芬兰成人癫痫患者(n=237)的调查数据进行分析.
    结果:仅基于少数现有法院案件,癫痫患者面临的问题似乎与其他残疾人群体面临的问题相似。我们的调查受访者报告的最常见问题与医疗保健服务(73%)和工作(54%)有关,其次是家庭(25%),虐待(25%),住房(24%)和商品及服务(19%)。患有难治性癫痫和感知到的偏见似乎都与经历日常问题有关。
    结论:这项针对癫痫患者所经历的日常问题的初步研究结果表明,他们在诉诸司法方面存在各种差距,甚至在像芬兰这样的发达国家。
    OBJECTIVE: The aim of this socio-legal pilot study is to gain insight into the access to justice for people with epilepsy in Finland by identifying the everyday problems experienced by them. Stigma, prejudice and their impact on the lives of people with epilepsy has been widely documented in the literature. Thus, we also wanted to explore whether there is a link between reported everyday problems and perceived prejudice.
    METHODS: In the first phase of the study, court cases were used to describe the everyday problems of people with epilepsy in Finland. In the second phase, descriptive statistical methods were used to analyse the survey data collected from adults with epilepsy in Finland (n = 237).
    RESULTS: Based on only a few existing court cases, the problems faced by people with epilepsy seem to be similar to those faced by other groups of people with disabilities. The most common problems reported by our survey respondents were related to healthcare services (73 %) and work (54 %), followed by family (25 %), mistreatment (25 %), housing (24 %) and goods and services (19 %). Both having refractory epilepsy and perceived prejudice seem to be linked with experiencing everyday problems.
    CONCLUSIONS: The results of this pilot study on the everyday problems experienced by people with epilepsy suggest that there are various gaps in their access to justice, even in a developed EU country like Finland.
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  • 文章类型: Journal Article
    目标:堪萨斯城的一个基层环境正义组织一直在研究居住在美国最大的分类铁路场的居民对空气污染的不成比例的暴露。先前的分析表明,居住在靠近毒性释放库存(TRI)设施和铁路场的哮喘患者的哮喘恶化风险有限。在这项研究中,我们评估了地理哮喘和环境差异,进一步探索社区层面的差距。
    方法:这是一项针对人群水平哮喘发病率的横断面研究,其中包括所有哮喘发作率和急性哮喘发作率(紧急护理,急诊科,住院)。从人口普查区质心到最近的TRI设施的距离,计算了铁路和高速公路。使用Kendallτ相关和多变量Poisson回归模型检查哮喘发病率和距离之间的关联。
    方法:我们使用地区儿科医院的电子病历数据,人口普查和环境保护局(EPA)空气监测数据。
    方法:在EPA研究时间范围内发现2+哮喘患者。
    结果:住宅与铁路站的距离与总体(-0.36(CI-0.41至-0.32))和急性(-0.27(CI-0.32至-0.22))哮喘发生率呈显著负相关。与南部方向性相比,最近的铁路场以北的地区的哮喘发生率升高(发生率比:1.38;CI1.35至1.41)。距最近的铁路站3公里的距离增加与总哮喘发生率降低26%有关。
    结论:观察到接近所有污染源类型与哮喘发病率之间存在显著负相关。这项社区一级的研究已成为社区参与的工具,并将用于支持拟议的地方政策。环境司法工作解决了涉及小,有限的数据集,如果数据存在。学术流行病学平台可能会重新考虑可接受的小人口研究方法,以便更好地为最需要的社区提供服务。
    OBJECTIVE: A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.
    METHODS: This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall\'s τ correlation and multivariable Poisson regression models.
    METHODS: We used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.
    METHODS: Patients with 2+ asthma encounters during the EPA study timeframe were identified.
    RESULTS: Residential distance from railyards exhibited a significant negative correlation with overall (-0.36 (CI -0.41 to -0.32)) and acute (-0.27 (CI -0.32 to -0.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3 km was associated with a decrease in overall asthma rates of 26%.
    CONCLUSIONS: Significant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.
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  • 文章类型: Journal Article
    目的:评估文化,社会和情感健康计划,旨在减少准备从监狱释放的土著妇女的心理困扰并增强其社会和情感健康。
    方法:混合方法;定性研究(对最重大变化的故事进行适应性反身主题分析)和心理困扰评估。
    方法:Boronia妇女预释放中心的土著和托雷斯海峡岛民妇女,珀斯,西澳大利亚,2021年5月和7月。
    方法:文化,社会和情绪健康计划(每周两天,共六周)。该计划包括介绍,工作坊,活动,小组讨论,以及旨在增强社交和情感健康的自我反思。
    方法:从对参与者的最重要变化的故事的反身主题分析中确定的主题和子主题;平均心理困扰的变化,根据项目前后的5项Kessler量表(K-5)进行评估。
    结果:16名受邀妇女中有14名完成了该计划;10名参加了评估。他们报告说改善了社会和情感健康,反映为与文化的联系增强,家庭,和社区。项目结束后,平均心理困扰较低(平均K-5得分,11.3;95%置信区间[CI],9.0-13.6)比计划前(9.0;95%CI,6.5-11.5;P=0.047)。
    结论:参与该计划的女性报告了个人成长,包括对自我的接受,对文化的接受和自豪,通过与文化和亲属关系的联系,反映出增强的社会和情感福祉。我们的初步调查结果表明,该计划可以提高原住民和托雷斯海峡岛民与司法系统接触的韧性。
    To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison.
    Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress.
    Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021.
    Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing.
    Themes and subthemes identified from reflexive thematic analysis of participants\' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program.
    Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047).
    The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.
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  • 文章类型: Journal Article
    背景:尽管人们普遍承认,诉诸民事司法(ATJ)是健康(SDOH)的关键社会决定因素,现有文献缺乏支持ATJ作为特定健康维度的SDOH的经验证据。
    方法:法律流行病学,横截面,2023年3月在香港对n=908的随机抽样参与者进行了邮政调查。收集的数据是对民事司法系统的看法,健康,和社会人口统计学。感知ATJ使用司法不可及性量表(IOJ)和感知司法不平等量表(PIJ)的修订版进行评估,即“修改的IOJ-PIJ”,由两个量表的原始13个项目中的12个组成,分为两个子域:“程序公平”,和“结果中立”。对于健康数据,使用香港版的世界卫生组织缩写生活质量问卷(WHOQOL-BREF(香港))评估生活质量,使用四项患者健康问卷(PHQ-4)评估心理困扰(包括焦虑和抑郁症状),使用Sangha的自我管理合并症问卷(SCQ)评估合并症。结构方程模型(SEM)用于研究感知的ATJ与测量的健康结果之间的关系。
    结果:SEM表明ATJ的两个子域与所有生活质量子域均具有显着负相关(B<0;p<0.05),除了在结果中性与社会关系之间;ATJ的两个子领域与焦虑和抑郁都有显著正相关(B>0;p<0.05);并且,在调整了年龄之后,只有“程序公平性”与合并症呈显著正相关(B>0;p<0.05)。
    结论:这项研究提供了经验证据,证明ATJ是特定健康方面的SDOH。这项研究的结果鼓励法律,政策,以及旨在改善ATJ的举措,以及法律和卫生部门通过卫生-司法伙伴关系的合作努力,来自更广泛的社区,通过加强ATJ来保障和促进公众健康。
    BACKGROUND: Although it is widely acknowledged that access to civil justice (ATJ) is a key social determinant of health (SDOH), the existing literature lacks empirical evidence supporting ATJ as a SDOH for specific dimensions of health.
    METHODS: A legal epidemiological, cross-sectional, postal survey was conducted on n = 908 randomly sampled participants in Hong Kong in March 2023. Data collected were perceptions of the civil justice system, health, and sociodemographics. Perceived ATJ was assessed using a modified version of the Inaccessibility of Justice scale (IOJ) and Perceived Inequality of Justice scale (PIJ), i.e. the \"modified IOJ-PIJ\", consisting of 12 of the original 13 items from both scales divided into two subdomains: \"procedural fairness\", and \"outcome neutrality\". For health data, quality of life was assessed using the Hong Kong version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF(HK)), psychological distress (including symptoms of anxiety and depression) was assessed using the four-Item Patient Health Questionnaire (PHQ-4), and having comorbidities was assessed using Sangha\'s Self-Administered Comorbidity Questionnaire (SCQ). Structural equation modelling (SEM) was used to investigate the relationships between perceived ATJ and the measured health outcomes.
    RESULTS: SEM demonstrated that both subdomains for ATJ had significantly negative associations (B < 0; p < 0.05) with all quality-of-life subdomains, except for between outcome neutrality with social relationships; both subdomains for ATJ had significantly positive association (B > 0; p < 0.05) with both anxiety and depression; and, after adjusting for age, only \"procedural fairness\" had significantly positive association (B > 0; p < 0.05) with having comorbidities.
    CONCLUSIONS: This study provided empirical evidence that ATJ is a SDOH for specific dimensions of health. The results of this study encourage laws, policies, and initiatives aimed at improving ATJ, as well as collaborative efforts from the legal and health sectors through health-justice partnerships, and from the broader community, to safeguard and promote public health by strengthening ATJ.
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  • 文章类型: Journal Article
    背景:返回实践是英格兰卫生和护理队伍中招募和保留专职卫生专业人员(AHP)的一种机制。不知道这如何影响具有受保护特征的人。
    目的:了解具有受保护特征的职业女性通过重返实践计划重返劳动力队伍的经验。
    方法:QUAL(半结构化访谈)+QUAL(焦点小组访谈)混合方法研究。12次在线半结构化访谈,返回实践AHP,其次是2个在线焦点小组。
    结果:我们的研究发现了一种新型的返回者,他们不得不将重返实践计划作为进入健康和社会护理的工具,因为他们无法找到工作。重返实践的主要动力是经济原因。
    结论:迄今为止,很少有证据表明领导者在回归实践计划时了解AHP的复杂性,他们可以为工作场所和当前存在的不平等做出巨大贡献。
    BACKGROUND: Return to practice is one mechanism for recruiting and retaining allied health professionals (AHPs) within the health and care workforce in England. It is not known how this affects persons with protected characteristics.
    OBJECTIVE: To understand experiences of AHPs with protected characteristics of returning to the workforce through a return to practice programme.
    METHODS: A QUAL (semistructured interviews) + qual (focus group interviews) mixed-methods study. 12 online semistructured interviews with return to practice AHPs, followed by 2 online focus groups.
    RESULTS: Our research identifies a new type of returners who have to use the return to practice programme as a vehicle to step into health and social care as they have not been able to find employment. A main driver to return to practice was financial reason.
    CONCLUSIONS: To date there, is little evidence of leaders understanding the complexities of AHPs in a return to practice programme, the considerable contribution they can make to the workplace and the current inequities that exist.
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  • 文章类型: Journal Article
    背景:基于校园的临床学习中心用于护理学生的实践和学习教育,可以成为提高学生对社会正义问题的认识和能力的场所。规范批判方法可以用作这些中心的教学工具,为学生准备动手关怀的情况,在这种情况下,社会规范可能会使结果产生偏差。
    目的:描述护理教师学习规范关键方法的概念,并在临床培训中心实施。
    方法:该研究基于对瑞典一所大学学院的10名教师的访谈。
    方法:使用现象学方法分析数据。
    结果:分析中出现了五类描述,描述了与规范关键方法相关的概念。这些类别是:个人发展和有意义的;容易与既定的护理概念整合;突出周围的力量;让学生采取规范关键举措的第一步时,需要依靠的东西;并帮助实施教学和教育。
    结论:面临提供规范批判的任务的教师,在基于校园的临床学习环境中对护生的实践教育与规范批评的核心原则存在矛盾,他们认为这是自然和挑衅的,同时。因此,我们需要不戏剧化的规范批评,并更好地准备教师如何使用它。教师将受益于后续活动和关于规范关键教学的正式合作,这样他们就有了讨论的背景,反映,互相学习.
    Campus-based clinical learning centres are used for practice and learning in nursing students\' education and can be arenas in which to enhance students\' awareness and competence in social justice issues. Norm-critical approaches can be used as pedagogical tools in these centres to prepare students for hands-on caring situations in which social norms can bias the outcome.
    To describe nursing teachers\' conceptions of learning norm-critical approaches and implementing them in a clinical training centre.
    The study is based on interviews with 10 teachers at a Swedish university college.
    The data was analysed using a phenomenographic approach.
    Five categories of description emerged in the analysis that described conceptions related to norm-critical approaches. These categories were: personally developing and meaningful; easily integrated with established nursing concepts; highlighting surrounding power; something to lean on when letting students take the first steps in norm-critical initiatives; and helping implementation in teaching and education.
    Teachers who are facing the task of providing norm-critical, practical education to nursing students in campus-based clinical learning environments are ambivalent towards the core principles of norm criticism, which they conceive as natural and provoking, at the same time. We therefore need to un-dramatise norm criticism and better prepare teachers in how to use it. Teachers would benefit from follow-up activities and formal collaborations regarding norm-critical teaching, so that they are given context to discuss, reflect, and learn from each other.
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  • 文章类型: Journal Article
    背景:将人工智能(AI)集成到医疗保健中引起了重大的伦理问题。在药学实践中,人工智能提供了有希望的进步,但也带来了道德挑战。
    方法:在中东和北非(MENA)地区的国家对501名药学专业人员进行了横断面研究。一份12项在线问卷评估了与在药学实践中采用人工智能相关的道德问题。通过SPSSv.27软件使用适当的统计检验分析了与道德问题相关的人口统计学因素。
    结果:参与者对患者数据隐私表示担忧(58.9%),网络安全威胁(58.9%)潜在的工作位移(62.9%),缺乏法律法规(67.0%)。技术知识和基本AI理解与更高的关注分数相关(p<0.001)。伦理影响包括知情同意的必要性,仁慈,正义,和使用AI的透明度。
    结论:研究结果强调了道德准则的重要性,教育,以及患者在采用人工智能方面的自主权。协作,数据隐私,公平的获取对于在药学实践中负责任地使用人工智能至关重要。
    BACKGROUND: Integrating artificial intelligence (AI) into healthcare has raised significant ethical concerns. In pharmacy practice, AI offers promising advances but also poses ethical challenges.
    METHODS: A cross-sectional study was conducted in countries from the Middle East and North Africa (MENA) region on 501 pharmacy professionals. A 12-item online questionnaire assessed ethical concerns related to the adoption of AI in pharmacy practice. Demographic factors associated with ethical concerns were analyzed via SPSS v.27 software using appropriate statistical tests.
    RESULTS: Participants expressed concerns about patient data privacy (58.9%), cybersecurity threats (58.9%), potential job displacement (62.9%), and lack of legal regulation (67.0%). Tech-savviness and basic AI understanding were correlated with higher concern scores (p < 0.001). Ethical implications include the need for informed consent, beneficence, justice, and transparency in the use of AI.
    CONCLUSIONS: The findings emphasize the importance of ethical guidelines, education, and patient autonomy in adopting AI. Collaboration, data privacy, and equitable access are crucial to the responsible use of AI in pharmacy practice.
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  • 文章类型: Journal Article
    背景:来自少数群体的个人在历史上面临社会不公正。来自代表性不足群体的人不太可能获得医疗保健服务和高等教育。对于在英国进行骨病本科学习期间代表性不足的学生的经历知之甚少。该项目的目的是探索在当前整骨疗法教育环境中,文化多样性和对来自代表性不足群体的患者的信念的认识,并评估学生管理来自不同群体的患者的准备情况。该项目还旨在调查代表性不足的学生在培训期间的教育经历,以及他们对可能支持更高水平的招聘和成就的变化的看法。在互动讲习班上与利益攸关方讨论了调查结果,目的是为行动和变革提出建议。
    方法:变革行动研究范式为这个混合方法项目提供了信息。它包括:1/使用多维文化谦卑量表(MCHS)对英国所有七个整骨疗法教育提供者的学生进行的调查;2/一系列焦点小组,学生来自代表性不足的群体(女性,残疾学生,来自少数民族背景的学生,和学生确定为LGBTQIA+);和3/一个研讨会论坛,讨论发现。
    结果:共有202名参与者完成了MCHS和人口统计问卷,并进行了七个重点小组。开发了一个模型来描述参与者的培训经验,包括两个主要主题:机构背景障碍(有四个子主题)和代表性不足的学生对公平的概念理解,多样性和包容性(EDI)。讲习班中确定的变革建议基于三个主题:机构,工作人员,和学生。
    结论:我们的发现证实了其他机构的结论,即迫切需要员工教育来创造和维护公平,英国整骨疗法教育机构的包容性环境,以支持所有学生,特别是那些代表性不足的群体。还需要澄清或修改机构EDI流程和政策,以确保其有用性,可访问性,和执行。
    BACKGROUND: Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students\' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change.
    METHODS: A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings.
    RESULTS: A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants\' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students\' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students.
    CONCLUSIONS: Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.
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