Ovbiagele Bruce
Stroke Center and Department of Neurology, UCLA Medical Center, Los Angeles, CA 90095, USA.
Crit Pathw Cardiol. 2010 Jun;9(2):88-93. doi: 10.1097/HPC.0b013e3181dc8d54.
Ethnic minorities are generally at higher risk for experiencing a stroke and dying from a stroke than non-Hispanic Whites, but are less likely to have optimal stroke risk factor control. Part of this ethnic disparity in stroke outcomes can be attributed to sociocultural factors. As such, there is a need to use culturally sensitive qualitative analysis to explore various strategies for enhancing vascular risk reduction in minority stroke patients encountered in under-resourced health systems. One potential strategy could be the use of nurse-led group clinics. Group clinics might be a relatively straightforward way of supplementing physician-centered efforts to improve outcomes in under-resourced settings by improving efficiency and encouraging patient self-management. However, research is limited on the implementation of group clinics among low-income, ethnic minority populations. This study aimed to obtain information about the feasibility of successfully implementing group clinics to boost treatment adherence among elderly Spanish-speaking only stroke patients within an under-resourced urban health system. A total of 13 Spanish-only speaking participants aged >or=60 years discharged from a local government hospital in Los Angeles within 18 months of an index ischemic stroke, and 6 caregivers, engaged in focus groups and interviews. Structured interviews were conducted with 11 care providers and 9 administrators at the hospital. Framework analysis examined the data and elicited themes necessary for successful execution of nurse-led group clinics for promoting vascular risk reduction treatment adherence among Elderly Spanish-only speaking stroke patients encountered within an urban health care system.
与非西班牙裔白人相比，少数族裔患中风及死于中风的风险通常更高，但他们获得最佳中风风险因素控制的可能性较小。中风结果方面的这种种族差异部分可归因于社会文化因素。因此，需要运用具有文化敏感性的定性分析方法，来探索各种策略，以提高资源匮乏的医疗系统中少数族裔中风患者的血管风险降低水平。一种潜在策略可能是采用由护士主导的小组诊所。小组诊所可能是一种相对直接的方式，通过提高效率和鼓励患者自我管理，来补充以医生为中心的努力，从而改善资源匮乏环境中的治疗效果。然而，关于在低收入少数族裔人群中实施小组诊所的研究有限。本研究旨在获取有关在资源匮乏的城市医疗系统中成功实施小组诊所，以提高仅说西班牙语的老年中风患者治疗依从性的可行性信息。共有13名年龄≥60岁、在洛杉矶当地一家政府医院因首次缺血性中风出院后18个月内仅说西班牙语的参与者，以及6名护理人员参加了焦点小组和访谈。对该医院的11名护理人员和9名管理人员进行了结构化访谈。框架分析对数据进行了审查，并提炼出成功实施由护士主导的小组诊所，以促进城市医疗系统中仅说西班牙语的老年中风患者血管风险降低治疗依从性所需的主题。
