Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
National Development Team for Inclusion, First Floor, 30-32 Westgate Buildings, Bath, BA1 1EF, UK.
BMC Health Serv Res. 2018 Dec 4;18(1):931. doi: 10.1186/s12913-018-3757-7.
The UK Equality Act 2010 requires providers of health services to make changes or 'reasonable adjustments' to their practices in order to protect disabled people from discrimination or disadvantage when accessing care. Existing evidence suggests that despite this legislation, health services are not always providing reasonably adjusted care for disabled people. This paper presents the perspectives of disabled people themselves in relation to their experiences of accessing reasonable adjustments in hospitals in England.
Twenty-one semi-structured interviews were held with disabled people who had a recent experience of hospital care in England. Participants were asked about the extent to which the hospital provided reasonably adjusted care, and if necessary, how they thought the provision of reasonable adjustments could be improved. Each interview was anonymised and transcribed, and the data analysed using thematic analysis.
Participants reported mixed experiences about whether and how reasonable adjustments were provided: some shared positive examples of good practice; others spoke about difficult encounters and limited provision. Recommendations made include a need for culture change in how reasonable adjustments are perceived and enacted; improvements in identifying the needs of disabled people; improvements to the hospital environment and the provision of information; and the need to involve disabled people themselves in the process of change.
Gaps remain in how reasonable adjustments are provided for disabled people accessing hospital care. It is important for hospital staff to listen to the perspectives of disabled people about the provision of reasonable adjustments, and make improvements as necessary. Hospital staff could also do more to share good practice in relation to the provision of reasonable adjustments to effectively inspire and embed positive change.
2010 年英国平等法案要求医疗服务提供者对其做法进行更改或“合理调整”,以保护残疾人在获得护理时免受歧视或不利待遇。现有证据表明,尽管有这项立法,但卫生服务部门并非总是为残疾人提供合理调整的护理。本文介绍了英格兰医院中残疾人本身对获得合理调整的体验的看法。
对 21 名在英格兰最近有医院护理经历的残疾人进行了半结构化访谈。询问参与者医院提供合理调整护理的程度,如果有必要,他们认为如何可以改进合理调整的提供。每次访谈均进行匿名处理并进行转录,使用主题分析对数据进行分析。
参与者报告了有关合理调整的提供情况的混合体验:一些人分享了良好实践的积极例子;另一些人则谈到了困难的遭遇和有限的提供。提出的建议包括需要改变对合理调整的看法和实施方式;需要改进确定残疾人需求的方法;改善医院环境和提供信息;并需要让残疾人本身参与变革过程。
在为接受医院护理的残疾人提供合理调整方面仍存在差距。医院工作人员倾听残疾人对合理调整提供的看法并进行必要的改进非常重要。医院工作人员还可以更多地分享有关提供合理调整的良好实践,以有效地激发和嵌入积极的变革。