Walls Melissa L, Gonzalez John, Gladney Tanya, Onello Emily
From the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, Duluth, MN (MLW); Department of Psychology, Bemidji State University, Bemidji, MN (JG); Department of Sociology and Criminal Justice, University of St. Thomas, St. Paul, MN (TG); Department of Family Medicine/Community Health, University of Minnesota Medical School-Duluth, Duluth, MN (EO).
J Am Board Fam Med. 2015 Mar-Apr;28(2):231-9. doi: 10.3122/jabfm.2015.02.140194.
This article reports on the prevalence and correlates of microaggressive experiences in health care settings reported by American Indian (AI) adults with type 2 diabetes mellitus (T2DM).
This community-based participatory research project includes two AI reservation communities. Data were collected via in-person article-and-pencil survey interviews with 218 AI adults diagnosed with T2DM.
Greater than one third of the sample reported experiencing a microaggression in interactions with their health providers. Reports of microaggressions were correlated with self-reported history of heart attack, worse depressive symptoms, and prior-year hospitalization. Depressive symptom ratings seemed to account for some of the association between microaggressions and hospitalization (but not history of heart attack) in multivariate models.
Microaggressive experiences undermine the ideals of patient-centered care and in this study were correlated with worse mental and physical health reports for AIs living with a chronic disease. Providers should be cognizant of these subtle, often unconscious forms of discrimination.
本文报告了患有2型糖尿病（T2DM）的美国印第安（AI）成年人在医疗保健环境中遭受微侵犯经历的患病率及其相关因素。
这个基于社区的参与性研究项目包括两个AI保留地社区。通过对218名被诊断患有T2DM的AI成年人进行面对面的纸笔问卷调查访谈来收集数据。
超过三分之一的样本报告在与医疗服务提供者的互动中经历过微侵犯。微侵犯的报告与自我报告的心脏病发作史、更严重的抑郁症状以及上一年的住院情况相关。在多变量模型中，抑郁症状评分似乎解释了微侵犯与住院（但不是心脏病发作史）之间的部分关联。
微侵犯经历破坏了以患者为中心的护理理念，在本研究中，与患有慢性病的AI人群较差的身心健康报告相关。医疗服务提供者应该意识到这些微妙的、通常是无意识的歧视形式。
