Professor of Nursing, Eastern University, St. Davids, PA.
J Prof Nurs. 2013 Sep-Oct;29(5):309-17. doi: 10.1016/j.profnurs.2012.05.009. Epub 2013 Aug 29.
The current economic climate of the United States has contributed to the crisis in health care delivery services. As a result, an increasing number of individuals present as poor and vulnerable. Currently, poverty rates in the United States are climbing, with literature clearly reflecting an association between poverty and ill health. With a number of economic barriers to health care, it has been suggested that health care providers' attitudes and subtle prejudices have also contributed to access. These preconceived negative attitudes can shame and embarrass vulnerable, homeless, immigrant, and poor individuals from attempting to access care. This research attempted to identify preconceived attitudes that second-degree baccalaureate nursing students possess prior to clinical exposure to poor and homeless populations through qualitative and quantitative investigative methods. Senior-level community health students preparing to deliver health care at a suburban homeless day shelter were asked to describe their experiences and opinions relative to homeless and poor persons before and after their actual contact with this population. Collected data suggest that there are subtle stereotyping and negative attitudes regarding the plight of overtly impoverished individuals before rendering care. After an 8-hour clinical experience with the aforementioned population, attitudes toward the vulnerable slightly improved, suggesting that clinical and didactic exposure to the plight of poor populations may assist to sensitize student nurses to exude compassion through a holistic therapeutic nurse-client relationship.
美国当前的经济形势导致了医疗服务提供方面的危机。因此,越来越多的人表现出贫困和脆弱的状态。目前,美国的贫困率正在攀升,文献清楚地反映了贫困与健康状况不佳之间的关联。由于医疗保健存在许多经济障碍,有人认为医疗保健提供者的态度和微妙偏见也对获取医疗保健造成了影响。这些先入为主的消极态度可能会使脆弱、无家可归、移民和贫困的个人感到羞耻和尴尬,从而不敢尝试获得医疗保健。这项研究试图通过定性和定量调查方法,确定在临床接触贫困和无家可归人群之前,二年级护理专业学生所拥有的先入为主的态度。准备在郊区无家可归者日间收容所提供医疗保健的社区卫生专业高年级学生被要求描述他们在实际接触该人群之前和之后对无家可归者和贫困人口的经历和看法。收集的数据表明,在提供护理之前,对于明显贫困的人的困境存在微妙的刻板印象和消极态度。在与上述人群进行了 8 小时的临床接触后,对弱势群体的态度略有改善,这表明对贫困人群困境的临床和理论接触可能有助于使护理学生通过整体治疗性护士-患者关系表现出同情心。