Höglund Anna T, Carlsson Marianne, Holmström Inger K, Kaminsky Elenor
Department of Public Health and Caring Sciences, Box 564, SE-751 22, Uppsala, Sweden.
University of Gävle, 801 76, Gävle, Sweden.
Int J Equity Health. 2016 Sep 21;15(1):152. doi: 10.1186/s12939-016-0447-0.
The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person's human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses.
The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one's own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions.
The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments.
The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but could easily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.
瑞典《医疗保健法》规定,应根据需求提供医疗保健服务,并尊重每个人的人格尊严。目标是实现全体人口的健康公平。尽管如此,研究表明瑞典的医疗保健服务并非总是平等提供的。这在电话护理中也有体现。因此,本研究的目的是调查教育干预是否以及如何能够提高电话护士对医疗保健公平性的认识。
本研究采用准实验设计,设有一个干预组和一个对照组。在教育干预之前对两组进行基线测量,之后进行随访测量,使用一份针对本研究设计的问卷,其中评估了不同年龄、性别和种族的虚构人物在诸如对自己生活的掌控权、生活质量和歧视经历等方面的情况。教育干预包括一次网络讲座、文献资料和一次研讨会,内容涵盖与性别、年龄和种族相关的医疗保健不平等方面,以及将性别和交叉性理论作为这些情况的解释模型。
结果显示,干预组在干预前后几乎没有显著差异。对照组在第二次测量中也几乎没有发现显著差异,尽管该组未进行干预。原因可能是所使用的工具不够灵敏,无法检测到预期的对医疗保健公平性认识的提高,或者仅仅是填写问卷这一行为就可能产生某种干预效果。在所有评估中,出生在瑞典的年轻虚构人物被评定的美好生活指数高于出生在欧洲以外且年龄较大的虚构人物。
研究结果表明,在不同的医疗保健环境中,仍需对医疗保健公平性进行教育和讨论。该干预措施和问卷是为电话护士设计的,但可以轻松调整以适用于其他需要提高对医疗保健公平性认识的专业群体。