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芬兰罗姆成年人初级保健需求未得到满足中感知不公正待遇的作用。

The Role of Perceived Unjust Treatment in Unmet Needs for Primary Care Among Finnish Roma Adults.

机构信息

Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland.

Finnish Institute for Health and Welfare, 00271 Helsinki, Finland.

出版信息

Int J Environ Res Public Health. 2020 Aug 12;17(16):5825. doi: 10.3390/ijerph17165825.

Abstract

The main goal in developing services is to guarantee equal access to healthcare services that are suited to the patients' needs. Previous studies have shown that the Roma are more likely to experience unjust treatment in health services than the general population. This study examines the association between perceived unjust treatment in healthcare and self-assessed unmet need for primary care provided by general practitioners (GPs) and nurses among the Finnish Roma. The data from the Finnish Roma Wellbeing Study (Roosa), conducted in 2017-2018, were used. Snowball sampling was used in recruiting study participants ( = 365, 61% women). Logistic regression was used to test the association between perceived unjust treatment and unmet need for primary care. Confounders used were gender, age, marital status, education, employment, and self-rated health. Those who had experienced unjust treatment in healthcare were more likely to report unmet need for care provided by GPs (odds ratios (OR) = 6.44; < 0.001) and nurses (OR = 11.18; < 0.001) than those who felt that they had been treated justly. This association remained after adjustments for the confounders. Bidirectional guidance between the Roma and service providers should be improved and the Roma communities involved in service development using participatory methods.

摘要

制定服务计划的主要目标是确保患者能够平等获得适合其需求的医疗服务。以往的研究表明,与一般人群相比,罗姆人在医疗服务中更有可能受到不公正待遇。本研究考察了在芬兰罗姆人群中,医疗保健中感知到的不公正待遇与初级保健医生(GP)和护士提供的初级保健需求未得到满足之间的关联。本研究使用了 2017-2018 年进行的芬兰罗姆人健康状况研究(Roosa)的数据。采用雪球抽样招募研究参与者(=365,61%为女性)。使用逻辑回归检验感知到的不公正待遇与初级保健需求未得到满足之间的关联。使用的混杂因素包括性别、年龄、婚姻状况、教育、就业和自我评估的健康状况。与那些认为自己受到公正待遇的人相比,那些在医疗保健中经历过不公正待遇的人更有可能报告初级保健医生(比值比(OR)=6.44;<0.001)和护士(OR=11.18;<0.001)提供的护理需求未得到满足。在调整混杂因素后,这种关联仍然存在。应改善罗姆人和服务提供者之间的双向指导,并通过参与性方法让罗姆社区参与服务开发。

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