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在教育卫生专业人员以满足来自少数民族群体的患者和其他服务使用者的多样化需求方面存在的问题。

Issues in educating health professionals to meet the diverse needs of patients and other service users from ethnic minority groups.

作者信息

Chevannes Mel

机构信息

Nursing and Health Service Provision, School of Health, University of Wolverhampton, UK.

出版信息

J Adv Nurs. 2002 Aug;39(3):290-8. doi: 10.1046/j.1365-2648.2002.02276.x.

Abstract

AIM

The main aim of the study was to undertake training needs analysis among a multi-professional group for the purpose of improving care for ethnic minority patients and other service users.

BACKGROUND

Evidence from the literature identifies that some of the explanations advanced for the failure of health professionals to meet the needs of ethnic minorities include lack of understanding of cultural diversities, racism, racial stereotyping, lack of knowledge, exclusivity, and ethnocentrism. While these issues have been addressed in different countries, little work has been carried out to examine these from the perspective of health professionals caring for ethnic minorities. This study is therefore an attempt to find out what health professionals know about caring for patients and other service users from minority ethnic groups and their perception of training needs in this area of work.

METHODS

A pre- and post-training design phase structured the qualitative approach. A purposive sample of individuals working across five health service organizations located in a multi-racial city yielded a multi-professional group of participants. Views of 22 participants were obtained by semi-structured interviews at a pretraining phase. Training needs of health professionals drew on Walklin's (1992) six stages used to structure data collection, data analysis and delivery of training. The post-training phase used questionnaires to evaluate immediate learning that based on a 4-week period of reflection and applied to practice. The questionnaires were complemented by a facilitator-lead focus group.

RESULTS

The majority of the participants confirmed that no attention was given in their initial education to the health care needs of minority ethnic groups. Instead, participants engaged in self-initiated learning to improve their knowledge and understanding. The issue of communication was viewed with dissatisfaction and seen as affecting the sufficiency of caring for these patients. All participants rated meeting the needs of ethnic minorities as very important and believed that they had gained a better understanding of the concepts of ethnicity and race and resources available in local communities as a result of the training. They also reported changes in thinking about ethnic minorities and had started to acquire greater confidence to engage with colleagues about different cultural values and practices and the implications of these for caring. While a quarter of the participants had transferred some learning to practice, the majority were not able to bring about any change. This majority response challenged the sustainability of learning about ethnic minorities when training takes place away from the context in which professionals practise.

CONCLUSION

Training embedded in clinical and nonclinical environment where patients and other service users and professionals interact is offered as a major finding.

摘要

目的

本研究的主要目的是在一个多专业群体中进行培训需求分析,以改善对少数民族患者及其他服务使用者的护理。

背景

文献证据表明,对于卫生专业人员未能满足少数民族需求的一些解释包括对文化多样性缺乏理解、种族主义、种族刻板印象、知识匮乏、排外性和民族中心主义。虽然这些问题在不同国家都已得到解决,但从照顾少数民族的卫生专业人员的角度对这些问题进行审视的工作却很少。因此,本研究试图了解卫生专业人员对照顾少数民族患者及其他服务使用者的了解程度,以及他们对该工作领域培训需求的看法。

方法

采用培训前和培训后设计阶段构建定性研究方法。从位于一个多民族城市的五个卫生服务机构中选取有目的的个体样本,形成一个多专业参与群体。在培训前阶段,通过半结构化访谈获取了22名参与者的观点。卫生专业人员的培训需求借鉴了沃克林(1992)用于构建数据收集、数据分析和培训交付的六个阶段。培训后阶段使用问卷来评估基于4周反思期并应用于实践的即时学习情况。问卷由主持人主导的焦点小组进行补充。

结果

大多数参与者确认,他们在初始教育中没有关注少数民族的医疗保健需求。相反,参与者通过自主学习来提高自己的知识和理解。沟通问题受到不满,被视为影响对这些患者护理的充分性。所有参与者都认为满足少数民族需求非常重要,并认为通过培训他们对种族和民族概念以及当地社区可用资源有了更好的理解。他们还报告了对少数民族看法的变化,并开始更有信心与同事讨论不同的文化价值观和做法及其对护理的影响。虽然四分之一的参与者将一些学习内容应用到了实践中,但大多数人未能带来任何改变。这种多数人的反应对在专业人员实际工作环境之外进行培训时关于少数民族学习的可持续性提出了挑战。

结论

嵌入患者、其他服务使用者和专业人员互动的临床和非临床环境中的培训是一项主要发现。

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