Logan Rachel G, Daley Ellen M, Vamos Cheryl A, Louis-Jacques Adetola, Marhefka Stephanie L
University of South Florida, Tampa, Florida, USA.
Qual Health Res. 2021 May;31(6):1169-1182. doi: 10.1177/1049732321993094. Epub 2021 Feb 23.
While family planning care (FPC) visits may serve as opportunities to address gaps in knowledge and access to limited resources, young Black women may also face structural barriers (i.e., racism, discrimination, bias) to engaging in care due to the intersections of racial identity, age, and socioeconomic status. Findings from interviews with 22 Black women, ages 18 to 29 years, about the lived experience of FPC highlighted dynamic patient-provider encounters. Women's narratives uncovered the following essences: silence around sex impedes engagement in care, patient-provider racial concordance as protection from harm, providers as a source of discouragement and misinformation, frustration as a normative experience, decision making excludes discussion and deliberation, medical mistrust is pervasive and a part of Black consciousness, and meaningful and empathic patient-provider encounters are elusive. Health systems should prioritize developing and enhancing young Black women's relationship with FPC providers to help mitigate persistent inequities that perpetuate disadvantage among this population.
虽然计划生育护理(FPC)访视可能是解决知识差距和获取有限资源的机会,但年轻黑人女性由于种族身份、年龄和社会经济地位的交叉,在接受护理方面也可能面临结构性障碍(即种族主义、歧视、偏见)。对22名年龄在18至29岁之间的黑人女性进行的关于FPC生活经历的访谈结果突出了医患之间动态的互动。女性的叙述揭示了以下要点:对性话题的沉默阻碍了她们接受护理,医患种族一致性可作为免受伤害的保护,医护人员是造成气馁和错误信息的源头,沮丧是一种常态体验,决策过程缺乏讨论和审议,医疗不信任普遍存在且是黑人意识的一部分,而有意义且能产生同理心的医患互动难以实现。卫生系统应优先发展和加强年轻黑人女性与FPC医护人员的关系,以帮助缓解持续存在的不平等现象,这些不平等现象使该人群长期处于不利地位。