VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts.
Womens Health Issues. 2020 Mar-Apr;30(2):113-119. doi: 10.1016/j.whi.2019.10.003. Epub 2019 Nov 14.
In the past decade, the U.S. Department of Veterans Affairs (VA) has responded to a dramatic increase in women veterans seeking care by expanding Women's Health training to more than 5,000 women's health primary care providers and changing the culture of the VA to be more inclusive of women veterans. These initiatives have resulted in increased patient satisfaction and quality of care, but have focused mostly on primary care settings. Less is known about women's experiences in specialty care within VA. This qualitative study sought to examine women veterans' experiences with VA specialty care providers, with a focus on cardiovascular, musculoskeletal, and mental health care settings.
Semistructured interviews were conducted with 80 women veterans who served during the Iraq and Afghanistan conflicts at four VA facilities nationwide. Interviews focused on understanding women veterans' experiences with VA specialty care providers, including their perceptions of gender bias.
Four major themes emerged from interviews, including that 1) women did not feel that VA specialty care providers listened to them or took their symptoms seriously, 2) women were told their health conditions or symptoms were attributable to hormonal fluctuations, 3) women noted differences in care based on whether the VA specialty provider was male or female, and 4) women provided recommendations for how gender-sensitive specialty care might be improved.
This study is the first to highlight the perceived gender bias experienced by women veterans in VA specialty care. Women felt that their symptoms were disregarded or diminished by their specialty care providers. Although women veterans report positive experiences within women's health clinics and the primary care setting, their negative experiences in VA specialty care suggest that some providers may harbor unintentional or unconscious gender biases.
在过去的十年中，美国退伍军人事务部（VA）通过向超过 5000 名女性健康初级保健提供者扩大女性健康培训，并改变 VA 的文化以更加包容女性退伍军人，应对寻求护理的女性退伍军人人数的急剧增加。这些举措提高了患者满意度和护理质量，但主要集中在初级保健环境。在 VA 内，关于女性在专科护理中的体验知之甚少。这项定性研究旨在检查女性退伍军人在 VA 专科护理提供者方面的体验，重点关注心血管、肌肉骨骼和心理健康护理环境。
在全国四个 VA 设施中，对 80 名在伊拉克和阿富汗冲突期间服役的女性退伍军人进行了半结构化访谈。访谈重点是了解女性退伍军人在 VA 专科护理提供者方面的体验，包括他们对性别偏见的看法。
访谈中出现了四个主要主题，包括 1）女性认为 VA 专科护理提供者没有倾听她们的意见或认真对待她们的症状，2）女性被告知她们的健康状况或症状归因于荷尔蒙波动，3）女性注意到基于 VA 专科提供者是男性还是女性，护理存在差异，以及 4）女性提出了如何改善性别敏感的专科护理的建议。
这项研究首次强调了女性退伍军人在 VA 专科护理中经历的感知性别偏见。女性认为她们的症状被专科护理提供者忽视或轻视。尽管女性退伍军人在妇女健康诊所和初级保健环境中报告了积极的体验，但她们在 VA 专科护理中的负面体验表明，一些提供者可能怀有无意识或无意识的性别偏见。
