BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
J Clin Nurs. 2019 Oct;28(19-20):3459-3469. doi: 10.1111/jocn.14937. Epub 2019 Jul 17.
To explore how marginalised women perceive and rate equity-oriented health care at a primary care clinic using items that evaluate patients' experiences of care.
Despite an increased recognition of the importance of health care that is equity-oriented, and that understands the patient within the context of the broader social determinants of health, inequities in health remain prevalent around the world.
Items from the "EQUIP Primary Health Care" research programme were used to explore patients' experiences of equity-oriented health care. Women were invited to complete the questionnaire with the explicit aim of gaining their input to improve quality of care at the clinic. The Strengthening the Reporting of Observational Studies in Epidemiology Statement was followed for the study.
Sixty-seven women who experienced significant health and social inequities, and were seeking care at a women's only nurse practitioner primary health care clinic in Canada, were invited to complete the questionnaire. For quality improvement purposes, correlational analyses were used to explore women's experiences of care.
Women's responses showed that Promote Emotional Safety and Trust and Overall Quality of Care were the most highly correlated domains, indicating the importance of the health care team in establishing trusting relationships, particularly for women who experience stigma and negative judgement when seeking care.
Seeking feedback from patients on their experiences of care using items developed to explicitly tap into equity issues is useful in understanding how patients experience equity-oriented health care. Responses from the women highlight the importance of understanding not only the what of equity-oriented care but also the how.
The results of this study illustrate the importance of establishing trusting relationships, tailoring care, and using a nondiscriminatory approach when working with women who experience negative judgements when seeking care.
探讨边缘化妇女如何通过评估患者护理体验的项目感知和评价初级保健诊所的以公平为导向的医疗保健。
尽管人们越来越认识到以公平为导向、理解患者在更广泛的健康决定因素背景下的医疗保健的重要性，但全球范围内的健康不平等仍然很普遍。
使用“EQUIP 初级保健”研究计划的项目来探讨患者对公平导向医疗保健的体验。邀请妇女填写问卷，明确目的是为了从她们那里获得改善诊所护理质量的意见。该研究遵循了《加强观察性研究的报告》声明。
邀请了 67 名经历过重大健康和社会不平等的妇女在加拿大的一家仅限女性执业护士的初级保健诊所就诊，并邀请她们填写问卷。出于质量改进的目的，使用相关分析来探讨妇女的护理体验。
妇女的回答表明，促进情感安全和信任以及整体护理质量是相关性最高的两个领域，这表明医疗保健团队在建立信任关系方面的重要性，尤其是对于那些在寻求护理时经历污名化和负面评判的妇女。
使用专门针对公平问题开发的项目来征求患者对护理体验的反馈意见，有助于了解患者如何体验公平导向的医疗保健。妇女的回答强调了不仅要理解公平导向护理的“是什么”，还要理解“如何”实现。
本研究的结果说明了在与那些在寻求护理时经历负面评判的妇女合作时，建立信任关系、量身定制护理以及采用非歧视方法的重要性。
