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探索美国医疗保健系统中的歧视:伊朗老年移民的认知/经历

Exploring discrimination in american health care system: perceptions/experiences of older Iranian immigrants.

作者信息

Martin Shadi Sahami

机构信息

Hartford Foundation Geriatric Scholar, School of Social Work, University of Alabama, 220 Little Hall, Box 870314, Tuscaloosa, AL 35487-0314, USA.

出版信息

J Cross Cult Gerontol. 2012 Sep;27(3):291-304. doi: 10.1007/s10823-012-9168-z.

Abstract

The United States population is older and more diverse than ever before. Older Immigrant and minorities have been found to suffer from health care disparities. The National Institute of Health (2002) has identified discrimination as one of the factors that contributes to health disparities among immigrants and minority populations. The purpose of this qualitative phenomenological study was to explore older Iranian immigrants' perceptions/experiences of discrimination in their encounter with the American health care system. In depth interviews were conducted with 15 Iranians who had immigrated to the United States after the age of 50. The following major themes emerged from the study: 1) "American doctors don't discriminate", 2) class discrimination in American and Iranian health care system and 3) treating the illness and not the whole person. In general the participants reported that they did not perceive/experience discrimination in their encounter with the American health care system. In fact majority of the participants reported highly positive impressions of American health care providers. Some participants claimed that language barriers may have protected them from recognizing possible discriminations, while others reported that this absence of perceived discrimination may be a function of American provider's perception of a patient as an "illness" and not a whole person.

摘要

美国人口比以往任何时候都更加老龄化且更加多样化。研究发现,老年移民和少数族裔在医疗保健方面存在差异。美国国立卫生研究院(2002年)已将歧视确定为导致移民和少数族裔人群健康差异的因素之一。这项定性现象学研究的目的是探讨年长的伊朗移民在美国医疗保健系统中遭遇歧视时的认知/经历。对15名50岁以后移民到美国的伊朗人进行了深入访谈。该研究出现了以下主要主题:1)“美国医生不存在歧视”,2)美国和伊朗医疗保健系统中的阶层歧视,以及3)治疗疾病而非治疗整个人。总体而言,参与者报告称,他们在与美国医疗保健系统接触时并未察觉到/经历过歧视。事实上,大多数参与者对美国医疗保健提供者的印象非常积极。一些参与者声称,语言障碍可能使他们没有意识到可能存在的歧视,而另一些人则报告说,这种未察觉到的歧视可能是美国医疗服务提供者将患者视为“疾病”而非整个人的结果。

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