Winston Carole A, Leshner Paula, Kramer Jennifer, Allen Gillian
University of North Carolina at Charlotte, College of Health and Human Services, Department of Social Work, 9201 University City Boulevard, Charlotte, NC 28223, USA.
Omega (Westport). 2004;50(2):151-63. doi: 10.2190/qqkg-epfa-a2fn-ghvl.
While there is ample evidence to support the need for hospice and palliative care services for African Americans, only 8% of patients who utilize those services are from African-American communities. The underutilization of end-of-life and palliative care can be attributed to several barriers to service access including incompatibility between hospice philosophy and African-American religious, spiritual, and cultural beliefs; health care disparities; distrust of the medical establishment; physician influence; financial disincentives, and hospice admission criteria. Suggestions for dismantling barriers to care access include developing culturally competent professionals in the health and human services, expanding the philosophy of hospice to include spiritual advisors from client communities, and funding national initiatives to promote improved access to health care at all stages in the life cycle of members of all underserved communities.
虽然有充分证据表明非裔美国人需要临终关怀和姑息治疗服务，但使用这些服务的患者中只有8%来自非裔美国人社区。临终关怀和姑息治疗的利用不足可归因于服务获取的若干障碍，包括临终关怀理念与非裔美国人的宗教、精神和文化信仰之间的不相容性；医疗保健差距；对医疗机构的不信任；医生的影响；经济激励不足以及临终关怀入院标准。消除护理获取障碍的建议包括培养卫生和人类服务领域具有文化能力的专业人员，扩大临终关怀理念以纳入来自客户社区的精神顾问，以及为促进所有服务不足社区成员在生命周期各阶段更好地获得医疗保健的国家倡议提供资金。
