microaggressions

微侵略
  • 文章类型: Journal Article
    这篇综述旨在全面巩固和综合现有的关于医疗保健专业人员的看法和经验的实证研究机构,学员,和学生关于不同临床环境中的微侵略相互作用。审查方案已在国际前瞻性系统审查登记册(PROSPEROCRD42024546443)中注册。我们采用了乔安娜·布里格斯研究所的混合方法系统综述方法。在八个数据库中进行了全面的电子数据库搜索(Medline,Embase,CINAHL,PsycINFO,Scopus,WebofScience,社会科学数据库,和ProQuest论文和论文)从各自的成立日期到2023年10月1日。选择标准包括报告医疗专业人员在临床环境中发生的跨专业或专业内微攻击的实例的研究。学员,和学生认定为异性恋和无残疾。总的来说,37项研究符合资格标准,并被纳入我们的审查。我们的分析揭示了三个主要主题:临床环境中的种族微侵略,临床环境中的性别微侵袭,和临床环境中的宗教微侵略。研究必须深入研究这些经验,以更好地了解其长期后果,虽然政策举措应该旨在建立公平,包容性,尊重医疗环境。衔接研究和政策的合作努力对于消除障碍和培育包容性的医疗保健格局至关重要。
    This review aims to comprehensively consolidate and synthesize the existing body of empirical research on the perceptions and experiences of healthcare professionals, trainees, and students concerning microaggression interactions within diverse clinical settings. The review protocol was registered with the international prospective register of systematic reviews (PROSPERO CRD42024546443). We employed the Joanna Briggs Institute\'s mixed-methods systematic review approach. Comprehensive electronic database searches were conducted across eight databases (Medline, Embase, CINAHL, PsycINFO, Scopus, Web of Science, Social Science Database, and ProQuest Dissertation and Theses) from their respective inception dates up to October 1, 2023. The selection criteria included studies reporting instances of interprofessional or intra-professional microaggressions occurring in clinical environments among healthcare professionals, trainees, and students identifying as heterosexual and without disabilities. In total, 37 studies met the eligibility criteria and were included in our review. Our analysis revealed three primary themes: Racial Microaggressions in the Clinical Environment, Gender Microaggressions in the Clinical Environment, and Religious Microaggressions in the Clinical Environment. Research must delve deeply into these experiences to better understand their long-term consequences, while policy initiatives should be designed to establish equitable, inclusive, and respectful healthcare environments. Collaborative endeavors bridging research and policy are paramount to dismantling barriers and nurturing an inclusive healthcare landscape.
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  • 文章类型: Systematic Review
    目的:关于微侵害对性和性别少数群体的心理影响的定量数据已大大增加。在先前的研究中,已经从主题上确定了基于性取向和变性者以及基于性别的(跨性别)身份的微侵害。此外,联合女同性恋,同性恋,双性恋,变性者和性别多样化,酷儿/提问,和其他非异性恋(LGBTQ)微侵害可以与其他边缘化身份交叉检查。本系统综述综合了有关这些微攻击与心理相关性和结果之间关系的研究。方法:45项定量研究检查性取向,trans+identity-,或交叉的基于身份的微攻击和各种心理结果是从PsycINFO的系统搜索中确定的,心术,MEDLINE,和PubMed数据库。提取了有关微攻击的数据,合成,并按心理健康结果或相关因素分组。结果:基于性取向的微攻击是抑郁症的危险因素,焦虑,和内化的污名,并与心理困扰呈正相关,创伤应激症状,酒精的使用和滥用,大麻的使用和问题,自杀意念,和自杀企图。基于跨身份的微侵害与抑郁症呈正相关,自杀未遂,使用大麻。关于种族/民族的LGBTQ基于交叉身份的微侵犯与抑郁症有关,焦虑,和自杀意念。对其他基于交叉身份的微攻击的研究很少。结论:这些发现强调了各种微攻击对LGBTQ晚期青少年和早期成年人造成的心理伤害。未来的工作应侧重于对具有反式和交叉身份的个体的微侵害以及这些经历的保护因素。这篇综述还强调了在家庭中实施微观干预策略的社区研究的独特需求,学校,和工作环境,以减轻这些微攻击的有害影响。
    Purpose: Quantitative data on the psychological effects of microaggressions toward sexual and gender minority individuals have grown substantially. Sexual orientation-based and transgender and gender-diverse (trans+) identity-based microaggressions have been thematically identified in prior research. In addition, combined lesbian, gay, bisexual, transgender and gender-diverse, queer/questioning, and other non-heterosexual (LGBTQ) microaggressions can be examined intersectionally with other marginalized identities. This systematic review synthesizes research on the relationships among these microaggressions and psychological correlates and outcomes. Methods: Forty-five quantitative studies examining sexual orientation-, trans+ identity-, or intersectional identity-based microaggressions and various psychological outcomes were identified from systematic searches of PsycINFO, PsycARTICLES, MEDLINE, and PubMed databases. Data regarding microaggressions were extracted, synthesized, and grouped by mental health outcome or correlate. Results: Sexual orientation-based microaggressions were risk factors for depression, anxiety, and internalized stigma and were positively associated with psychological distress, traumatic stress symptoms, alcohol use and abuse, cannabis use and problems, suicidal ideation, and suicide attempt. Trans+ identity-based microaggressions were positively associated with depression, suicide attempt, and cannabis use. LGBTQ intersectional identity-based microaggressions concerning race/ethnicity were associated with depression, anxiety, and suicidal ideation. Research on other intersectional identity-based microaggressions is scarce. Conclusion: These findings emphasize the psychological harm inflicted by various microaggressions on LGBTQ late adolescents and early adults. Future work should focus on microaggressions toward individuals with trans+ and intersectional identities and protective factors for these experiences. This review also highlights the distinct need for community-based research on implementing microintervention strategies in family, school, and work environments to mitigate the harmful effects of these microaggressions.
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  • 文章类型: Systematic Review
    研究表明,微攻击会对边缘化社会群体成员的心理健康产生不利影响。
    本系统评价的目的是评估女同性恋者的微攻击暴露及其对心理健康的相关影响,同性恋,双性恋,变性人,Intersex,和酷儿(LGBTIQ)的人。
    Medline,Scopus,PsycINFO,CINAHL,和EMBASE一直搜索到2023年1月。确定了报告对LGBTIQ人群的微侵害暴露数据的研究。基于比值比(OR)和标准平均差(SMD)以及95%置信区间(95%CI),对微攻击暴露率以及微攻击与心理健康结果之间的关联进行了荟萃分析。通过具有随机效应的逆方差模型进行估计。
    审查过程导致了17项研究的选择,总共涉及9036名LGBTIQ人,其中6827人被认定为顺性者,和492个异性恋者,被包括在定量合成中。总的来说,LGBTIQ人群显示出微攻击的风险增加(SMD:0.89;95%CI[0.28,1.50]),变性人的风险最高(OR:10.0;95%CI[3.08,32.4])。微攻击与抑郁风险相关(SMD:0.21;95%CI[0.05,0.37]),焦虑(SMD:0.29;95%CI[0.17,0.40]),自杀未遂(OR:1.13;95%CI[1.08,1.18]),酗酒(OR:1.32;95%CI[1.13,1.54]),但不是自杀意念(OR:1.56;95%CI[0.64,3.81])和大麻滥用(OR:1.44;95%CI[0.82,2.55])。证据的质量受到研究数量少的限制。
    与顺性/异性恋同龄人相比,LGBTIQ人群遭受微侵害的风险更高,这可能会导致心理健康的后果。这些证据可能有助于提高公众对LGBTIQ心理健康需求的认识,并建议采取支持性策略和预防性干预措施(例如,支持性计划和消除污名化的努力)作为量身定制的医疗保健计划的一部分,旨在减少该人群的精神病发病率。
    UNASSIGNED: Research suggests that microaggressions detrimentally impact the mental health of members of marginalized social groups.
    UNASSIGNED: The aim of this systematic review was to assess the exposure to microaggressions and related implications on mental health of Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) people.
    UNASSIGNED: Medline, Scopus, PsycINFO, CINAHL, and EMBASE were searched until January 2023. Studies reporting data on the exposure to microaggressions toward LGBTIQ people were identified. Meta-analyses of rates of exposure to microaggression and of the association between microaggressions and mental health outcomes were based on odds ratio (OR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI), estimated through inverse variance models with random effects.
    UNASSIGNED: The review process led to the selection of 17 studies, involving a total of 9036 LGBTIQ people, of which 6827 identifying as cisgenders, and 492 as heterosexuals, were included in the quantitative synthesis. Overall, LGBTIQ people showed an increased risk of microaggression (SMD: 0.89; 95% CI [0.28, 1.50]), with Transgender people having the highest risk (OR: 10.0; 95% CI [3.08, 32.4]). Microaggression resulted associated with risk of depression (SMD: 0.21; 95% CI [0.05, 0.37]), anxiety (SMD: 0.29; 95% CI [0.17, 0.40]), suicide attempts (OR: 1.13; 95% CI [1.08, 1.18]), alcohol abuse (OR: 1.32; 95% CI [1.13, 1.54]), but not to suicidal ideation (OR: 1.56; 95% CI [0.64, 3.81]) and cannabis abuse (OR: 1.44; 95% CI [0.82, 2.55]). The quality of the evidence was limited by the small number of studies.
    UNASSIGNED: LGBTIQ people are at higher risk of microaggressions compared with their cisgender/heterosexual peers, which may lead to mental health consequences. This evidence may contribute to public awareness of LGBTIQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs and destigmatizing efforts) as parts of tailored health-care planning aimed to reduce psychiatric morbidity in this population.
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  • 文章类型: Journal Article
    目标:识别和绘制研究LGBTQIA+人群的知名度及其在医疗保健中的关系,以期为未来的研究和实践提供信息。
    方法:系统搜索了五个数据库中已发表和灰色文献。包括有关LGBTQIA+人群在医疗保健中的可见性的主要研究报告。两名审稿人独立筛选研究,直到达成可接受的协议水平。进行了叙事综合,并将发现映射到涉及三个子类别的微攻击分类法:微攻击,微攻击和微失效。
    结果:确定的微攻击包括微侮辱:\'对卫生专业人员的感知\'知识和舒适度\'和\'披露\';微攻击:\'歧视和污名\';微验证:\'访问和浏览服务\',\'遇到假设和刻板印象\',\'正在验证身份并包括关系\',和\'读取环境\'。
    结论:尽管社会接受度越来越高,微侵略仍然存在于医疗保健中。根据所包括的研究,LGBTQIA+社区内的群体在研究和医疗保健方面的可见性水平各不相同。
    结论:LGBT的知名度有限,QIA+人群及其在医疗保健中的关系缺乏知名度,这凸显了在研究中纳入所有LGBTQIA+社区观点的必要性。并确保卫生专业人员和临床服务有能力解决这一(内)能见度差距。
    To identify and map research into the visibility of LGBTQIA+ people and their relationships in healthcare, with the view to inform future research and practice.
    Five databases were systematically searched for published and grey literature. Primary research reporting on visibility of LGBTQIA+ people in healthcare was included. Two reviewers independently screened the studies until an acceptable level of agreement was reached. A narrative synthesis was conducted and findings mapped to a taxonomy of microaggressions involving three sub-categories: microinsults, microassaults and microinvalidations.
    The microaggressions identified included Microinsults: \'Perception of health professionals\' knowledge and comfort\' and \'Disclosure\'; Microassaults: \'Discrimination and stigma\'; Microvalidations: \'Accessing and navigating through services\', \'Encounters of assumptions and stereotypes\', \'Validating identities and including relationships\', and \'Reading the environment\'.
    Despite growing societal acceptance, microaggressions still exist within healthcare. Groups within LGBTQIA+ communities have varying levels of visibility in research and healthcare based on the studies included.
    The limited visibility of LGBT and lack of visibility of QIA+ people and their relationships in healthcare highlight the need to include the views of all LGBTQIA+ communities in research, and to ensure health professionals and clinical services are equipped to address this (in)visibility gap.
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  • 文章类型: Journal Article
    OBJECTIVE: Patient microaggressions affect practitioners in all fields of healthcare and especially psychiatry. In multiple studies, healthcare professionals reported high rates of patient microaggressions and discrimination. To date, this is the first scoping review of recommendations and trainings on patient microaggressions.
    METHODS: A scoping review of articles indexed in PubMed, PsycINFO, Medline, ERIC, and MedEdPORTAL was conducted from July 2020 to August 2020 to identify recommendations and solutions for healthcare professionals on responding to patient microaggressions.
    RESULTS: The review identified 27 studies that provide recommendations and trainings for healthcare professionals to address patient microaggressions. Twenty studies outlined recommendations for healthcare professionals and systems on how to respond to patient offenses. These 20 studies were grouped into establishing a supportive culture, addressing the microaggression, supporting the targets of microaggressions, discriminatory requests, and institutional responses. Six articles described trainings that equip providers with tools to address patient microaggressions, including the ERASE framework (\"Expect/Recognize/Address/Support/Establish, Encourage\"); Stop, Talk, and Roll; interrupting microaggressions; XYZ (\"I felt X when Y because Z\"); the ACTION model (\"Ask/Come/Tell/Impact/Own/Next\"); and the OWTFD tool (\"Observe/Why/Think/Feel/Desire\").
    CONCLUSIONS: Recommendations and trainings for the response to microaggressions are emerging, and results of trainings are encouraging. However, more work is needed to evaluate the effectiveness of these trainings in clinical settings and longitudinally.
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  • 文章类型: Journal Article
    Understanding the nature and consequences of LGBTQ microaggressions is critical to fostering equity and wellbeing among sexual and gender minorities. Yet little guidance is available for researchers seeking psychometrically robust measures of subtle LGBTQ slights, invalidations, and insults. To address this gap, we conducted a scoping review of multi-item quantitative measures that included at least one question addressing LGBTQ microaggressions. This article reports the study characteristics and psychometric properties of 27 original measures we identified and their subsequent adaptations. The article concludes with an assessment of strengths and limitations of LGBTQ microaggression measurement, highlighting aspects of measurement innovation on which future researchers can build. As microaggressions remain a powerful and underexplored mechanism of sexual and gender minority oppression, this review will help to both advance methodological quality in this critical research area and enhance our understanding of how microaggressions manifest in the lives of LGBTQ individuals.
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  • 文章类型: Journal Article
    自从Sue等人出版以来。(AmPsychol62:271-286,2007a,B)开创性文章,在这种种族微侵略的建构上,人们对心理学产生了巨大的学术兴趣-种族主义的微妙日常经历。在本文中,自2007年以来,我们对种族微侵略的心理学研究文献进行了综述,紧随种族微侵略的第一个综合分类法的出版,这为与种族微侵略有关的研究提供了概念框架和方向。然而,我们的综述表明,重要的概念和方法问题在以下三个领域仍有待解决:(1)什么是种族微侵略,它们对谁有影响;(2)为什么种族微侵略很重要;(3)当前如何研究种族微侵略,以及我们如何改进用于研究种族微侵略的方法.我们提出了进一步促进种族微侵略研究的建议,提高种族微观侵略研究的科学严谨性,并有助于对种族微侵略的概念和后果有更完整和更复杂的理解,这一结构无疑在少数族裔群体的许多成员中具有显著的和心理上的相关性。
    Since the publication of Sue et al. (Am Psychol 62:271-286, 2007a, b) seminal article, there has been an enormous scholarly interest in psychology on this construct of racial microaggressions-subtle everyday experiences of racism. In this paper, we provide a review of racial microaggressions research literature in psychology since 2007, following the publication of the first comprehensive taxonomy of racial microaggressions, which provided a conceptual framework and directions for research related to racial microaggressions. However, our review suggests that important conceptual and methodological issues remain to be addressed in the three domains: (1) what are racial microaggressions and who do they impact; (2) why are racial microaggressions important to examine; and (3) how are racial microaggressions currently studied and how might we improve the methodologies used to study racial microaggressions. We propose recommendations to further facilitate racial microaggressions research, improve the scientific rigor of racial microaggressions research, and contribute toward a more complete and sophisticated understanding of the concept and consequences of racial microaggressions-a construct that is undoubtedly salient and psychologically relevant among many members of racial minority groups.
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