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制度性种族主义对慢性肾衰竭患者治疗过程的影响。

Implications of institutional racism in the therapeutic itinerary of people with chronic renal failure.

机构信息

Universidade do Estado da Bahia, Bahia, Brazil,

Universidade Federal da Bahia, Brazil,

出版信息

Invest Educ Enferm. 2020 Jul;38(2). doi: 10.17533/udea.iee.v38n2e09.

Abstract

OBJECTIVES

To understand the implications of institutional racism in the therapeutic itinerary of patients with chronic renal failure (CRF) in the search for diagnosis and treatment of the disease.

METHODS

Descriptive, qualitative study developed with 23 people with CRF in a regional reference hospital for hemodialysis treatment in Northeast Brazil. Two techniques of data collection were used: semi-structured interview and consultation to the NEFRODATA electronic medical record. For systematization and analysis, the technique of content analysis was used.

RESULTS

Black and white people with CRF showed significant divergences and differences in their therapeutic itineraries: while white people had access to diagnosis during outpatient care in other medical specialties, black people were only diagnosed during hospitalization. In addition, white people had more access to private health plans when compared to black people, which doubles the possibility of access to health services. Moreover, even when the characteristics in the itinerary of black and white people were convergent, access to diagnosis and treatment proved to be more difficult for black people.

CONCLUSIONS

The study showed the presence of institutional racism in the therapeutic itinerary of people with kidney disease in which black people have greater difficulty in accessing health services. In this sense, there is a need to create strategies to face institutional racism and to consolidate the National Policy for Comprehensive Health Care of the Black Population.

摘要

目的

了解体制性种族主义对慢性肾衰竭(CRF)患者寻求疾病诊断和治疗过程中的治疗轨迹的影响。

方法

这是在巴西东北部一家区域参考医院进行的一项描述性、定性研究,共有 23 名 CRF 患者参与。使用了两种数据收集技术:半结构化访谈和对 NEFRODATA 电子病历的查阅。采用内容分析法对数据进行了系统分析。

结果

黑人和白人 CRF 患者的治疗轨迹存在显著差异:白人在其他医学专科的门诊期间就得到了诊断,而黑人只有在住院期间才得到诊断。此外,与黑人相比,白人更有可能获得私人健康计划,这使他们获得医疗服务的可能性增加了一倍。此外,即使黑人和白人的治疗轨迹特征趋同,黑人在获得诊断和治疗方面仍面临更大的困难。

结论

本研究表明,在肾病患者的治疗轨迹中存在体制性种族主义,黑人在获得医疗服务方面面临更大的困难。在这方面,需要制定策略来应对体制性种族主义,并巩固《国家黑人人口全面卫生保健政策》。

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