Leu Grace R, Links Anne R, Tunkel David E, Walsh Jonathan M, Ryan Marisa A, DiCarlo Heather, Jelin Eric B, Beach Mary Catherine, Boss Emily F
School of Medicine, Tufts University, Boston, Massachusetts, USA.
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Otolaryngol Head Neck Surg. 2021 Aug;165(2):282-289. doi: 10.1177/0194599820982639. Epub 2021 Jan 12.
We describe surgeon and parent perceptions of similarity toward each other and evaluate differences in the perceptions of similarity by race.
Observational cohort analysis.
Three outpatient sites.
Following consultations for children undergoing evaluation for 1 of 3 surgical procedures (tonsillectomy, hernia repair, circumcision), surgeons and parents rated their perception of cultural similarity toward each other on a 6-point Likert scale. Surgeon evaluation of 9 parent characteristics was measured with 7-point Likert scales. Regression analyses were performed to identify predictors of greater surgeon-perceived similarity and to assess associations of perceived similarity with evaluation of parent characteristics.
Most parents were women (n = 38, 84%), whereas surgeons were primarily men (n = 7, 54%). Of 45 parents, 23 (51%) were non-White, whereas only 4 of 13 clinicians (31%) were non-White. Mean perceived similarity score was 21.7 for parents (range, 10-24) and 18.2 for surgeons (range, 10-24). There was no difference in parent-perceived similarity based on race (White vs non-White parents, mean [SD] = 22.3 [3.4] vs 21.1 [3.0]; = .26). Surgeons perceived greater similarity with White parents (odds ratio = 4.78; 95% CI, 1.02-22.54; = .04) and parents with higher income (odds ratio = 11.84; 95% CI, 1.32-106.04; = .03). Greater perceived similarity by the surgeons was associated with more positive assessments of parent personality characteristics.
Surgeons perceived similarity more commonly with White parents, while parents' perception of similarity to surgeons was uniform regardless of parent race. Elucidating biases of surgeons may help to tailor interventions promoting culturally competent, equitable communication and decision making for elective surgery.
我们描述外科医生和家长对彼此相似性的看法，并评估不同种族在相似性认知上的差异。
观察性队列分析。
三个门诊机构。
在为接受三种外科手术（扁桃体切除术、疝气修补术、包皮环切术）之一评估的儿童进行会诊后，外科医生和家长用6点李克特量表对他们对彼此文化相似性的认知进行评分。外科医生用7点李克特量表对9项家长特征进行评估。进行回归分析以确定外科医生感知到更高相似性的预测因素，并评估感知到的相似性与家长特征评估之间的关联。
大多数家长为女性（n = 38，84%），而外科医生主要为男性（n = 7，54%）。45位家长中，23位（51%）为非白人，而13位临床医生中只有4位（31%）为非白人。家长感知到的相似性平均得分为21.7（范围10 - 24），外科医生为18.2（范围10 - 24）。基于种族的家长感知到的相似性无差异（白人家长与非白人家长，均值[标准差]=22.3[3.4]对21.1[3.0]；P = 0.26）。外科医生认为与白人家长的相似性更高（优势比 = 4.78；95%置信区间，1.02 - 22.54；P = 0.04），与收入较高的家长相似性更高（优势比 = 11.84；95%置信区间，1.32 - 106.04；P = 0.03）。外科医生感知到的更高相似性与对家长个性特征的更积极评价相关。
外科医生更常认为与白人家长相似，而家长对与外科医生相似性的认知无论其种族如何都是一致的。阐明外科医生的偏见可能有助于制定干预措施，促进在择期手术中进行具有文化能力、公平的沟通和决策。
