Ben-Harush Aya, Shiovitz-Ezra Sharon, Doron Israel, Alon Sara, Leibovitz Arthur, Golander Hava, Haron Yafa, Ayalon Liat
The Department of Social Work, Ruppin Academic Center, Emek Hefer, Israel.
The Early Childhood Education Program, The David Yellin Academic College of Education, Jerusalem, Israel.
Eur J Ageing. 2016 Jun 28;14(1):39-48. doi: 10.1007/s10433-016-0389-9. eCollection 2017 Mar.
This study investigated ageism among healthcare professionals in various therapeutic settings in Israel. Using a qualitative approach, the current study aimed to examine similarities and differences across healthcare disciplines. Three focus groups were conducted with physicians, nurses, and social workers. Data from each focus group were analyzed separately, and then commonalities and differences across the groups were evaluated. Three main themes relating to older adults emerged from the data. The first theme pertains to perceived difficulties that healthcare professionals experience in working with older adults and their family members; the second focuses on invisibility and discriminatory communication patterns; and the third theme relates to provision of inappropriate care to older adults. Similarities and differences across the three disciplines were found. The differences related mainly to the examples provided for manifestations of ageism in the healthcare system. Provision of inadequate treatment to older adults due to their age appeared to be the most complex theme, and is discussed at length in the Discussion. Briefly, the complexity stems from the fact that although some behaviors can be clearly described as inappropriate and undesirable, other behaviors such as avoidance of invasive medical procedures for older patients raise ethical dilemmas. Potentially, avoidance of invasive medical treatment can be perceived as compassionate care rather than as undertreatment due to ageist perceptions. A related dilemma, i.e., longevity versus quality-of-life, is also discussed in light of the finding that the balance of these two aspects changes as patients grow old.
本研究调查了以色列不同治疗环境中医护人员的年龄歧视现象。采用定性研究方法,本研究旨在考察不同医疗学科之间的异同。对医生、护士和社会工作者进行了三个焦点小组访谈。每个焦点小组的数据分别进行分析,然后评估各小组之间的共性和差异。数据中出现了与老年人相关的三个主要主题。第一个主题涉及医护人员在与老年人及其家庭成员合作时所感受到的困难;第二个主题关注忽视和歧视性的沟通模式;第三个主题与对老年人提供不适当护理有关。发现了三个学科之间的异同。差异主要体现在医疗系统中年龄歧视表现的示例上。由于老年人的年龄而对其提供不充分的治疗似乎是最复杂的主题,将在“讨论”部分详细讨论。简而言之,复杂性源于这样一个事实,即尽管有些行为可以明确描述为不适当和不可取,但其他行为,如避免对老年患者进行侵入性医疗程序,会引发伦理困境。潜在地,避免侵入性医疗治疗可能被视为关怀护理,而不是由于年龄歧视观念导致的治疗不足。鉴于随着患者年龄增长,这两个方面的平衡会发生变化这一发现,还讨论了一个相关的困境,即长寿与生活质量的问题。