新生儿重症监护病房护理质量的差异：一项关于家庭和临床医生描述的定性研究
Disparities in NICU quality of care: a qualitative study of family and clinician accounts.
作者信息
Sigurdson Krista, Morton Christine, Mitchell Briana, Profit Jochen
机构信息
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
出版信息
J Perinatol. 2018 May;38(5):600-607. doi: 10.1038/s41372-018-0057-3. Epub 2018 Apr 5.
OBJECTIVE
To identify how family advocates and clinicians describe disparities in NICU quality of care in narrative accounts.
STUDY DESIGN
Qualitative analysis of a survey requesting disparity stories at the 2016 VON Quality Congress. Accounts (324) were from a sample of RNs (n = 114, 35%), MDs (n = 109, 34%), NNPs (n = 55, 17%), RN other (n = 4, 1%), clinical other (n = 25, 7%), family advocates (n = 16, 5%), and unspecified (n = 1, <1%).
RESULTS
Accounts (324) addressed non-exclusive disparities: 151 (47%) language; 97 (30%) culture or ethnicity; 72 (22%) race; 41 (13%) SES; 28 (8%) drug use; 18 (5%) immigration status or nationality; 16 (4%) sexual orientation or family status; 14 (4%) gender; 10 (3%) disability. We identified three types of disparate care: neglectful care 85 (26%), judgmental care 85 (26%), or systemic barriers to care 139 (44%).
CONCLUSIONS
Nearly all accounts described differential care toward families, suggesting the lack of equitable family-centered care.
目的
确定家庭倡导者和临床医生在叙述中如何描述新生儿重症监护病房（NICU）护理质量的差异。
研究设计
对2016年VON质量大会上一项要求讲述差异故事的调查进行定性分析。共有324份叙述来自以下人员样本：注册护士（n = 114，占35%）、医生（n = 109，占34%）、新生儿护理专家（n = 55，占17%）、其他注册护士（n = 4，占1%）、其他临床人员（n = 25，占7%）、家庭倡导者（n = 16，占5%）以及未明确身份者（n = 1，占比不到1%）。
结果
324份叙述涉及非排他性差异：151份（47%）涉及语言；97份（30%）涉及文化或种族；72份（22%）涉及种族；41份（13%）涉及社会经济地位；28份（8%）涉及药物使用；18份（5%）涉及移民身份或国籍；16份（4%）涉及性取向或家庭状况；14份（4%）涉及性别；10份（3%）涉及残疾。我们识别出三种不同类型的护理差异：疏忽性护理85例（26%）、评判性护理85例（26%）或护理的系统性障碍139例（44%）。
结论
几乎所有叙述都描述了对家庭的差别护理，这表明缺乏公平的以家庭为中心的护理。
Zotero 插件