Johnstone Megan-Jane, Kanitsaki Olga
School of Nursing, Burwood, Melbourne, VIC 3125, Australia.
Health Policy. 2009 Apr;90(1):1-7. doi: 10.1016/j.healthpol.2008.08.007. Epub 2008 Oct 1.
Engaging patients as 'safety partners' with health service providers to help identify and rectify preventable adverse events in health care is being increasingly accepted in the USA, Australia, and elsewhere as a promising strategy to improve patient safety outcomes. The implications of this trend for patients and families of minority cultural and language backgrounds have not, however, been comprehensively considered. In this article, attention is given to briefly exploring the notion of patient participation in health care and the problematic transposition of the concept into patient safety discourse. The importance of recognising and responding to the critical relationship between culture, language and patient safety outcomes, and the possible benefits and risks of engaging patients of minority ethnic backgrounds in safety partnership programs are explored. It is suggested that if patient safety engagement/partnership programs are to perform well in cross-cultural health care contexts, they need to be supported by research evidence and appropriately informed by the perspectives and experiences of patients and families/nominated carers from minority cultural and language backgrounds. They also need to be appropriately supported by culturally competent policies and practices across the entire health care system. The importance of robust internationally comparative research on this issue is highlighted.
在美国、澳大利亚和其他地方,让患者作为医疗服务提供者的“安全伙伴”,以帮助识别和纠正医疗保健中可预防的不良事件,正日益被视为一种有望改善患者安全结果的策略。然而,这一趋势对少数族裔文化和语言背景的患者及其家庭的影响尚未得到全面考虑。在本文中,我们将简要探讨患者参与医疗保健的概念,以及将这一概念引入患者安全话语中所存在的问题。我们还将探讨认识和应对文化、语言与患者安全结果之间关键关系的重要性,以及让少数族裔背景的患者参与安全伙伴计划可能带来的益处和风险。研究表明,如果患者安全参与/伙伴计划要在跨文化医疗保健环境中发挥良好作用,就需要有研究证据的支持,并充分考虑来自少数族裔文化和语言背景的患者及其家庭/指定护理人员的观点和经验。整个医疗保健系统还需要有具备文化能力的政策和实践提供适当支持。本文强调了就此针对这一问题进行有力的国际比较研究的重要性。