Nguyen-Truong Connie K Y, Rakha Shameem, Eti Deborah U, Angelesco Lisa
Washington State University College of Nursing in Vancouver, Washington, United States.
Washington State University College of Education in Vancouver, Washington, United States.
Asian Pac Isl Nurs J. 2021;5(4):227-235. doi: 10.31372/20200504.1109.
Some patients and families of color, including Asian Americans, face significant adverse stressors due to living within a White-dominant society. Xenophobia and racism can impact health. Research evidence points to early exposure to adverse childhood experiences such as racial discrimination as being detrimental and having significant short-term and long-term impact on physical and mental health. The purpose of this commentary article is to illuminate the need of patients and their families who may seek health care providers (HCPs) to express their concerns and fears when issues of xenophobia and racism arise. Patients and families need space in a healthcare setting to feel heard and understood. Anti-Asian xenophobia and racism among medically underserved Asian Americans persists and has been heightened during the COVID-19 pandemic. We describe tenets of Critical Race Theory and AsianCrit, and use this lens to understand an example actual scenario, a counter-story, of a Vietnamese mother, and her Vietnamese-Chinese American family's experience with xenophobia and racism at a community recreation center and the subsequent communication of this experience with a HCP. We describe the impacts of these experiences of seeking healing including discontinuity of a HCP-patient-family relationship. It takes bravery for patients and families to tell their story of xenophobia and racism to a HCP. There are Asian Americans who are afraid to seek healthcare because of anti-Asian xenophobia and concerns about White fragility. Following, we highlight research evidence on implicit bias, also known as unconscious bias, as context about its persistent and widespread existence among healthcare professionals in general and the need to address this in healthcare. Implicit bias can influence care provided to a patient-family and the interactions between a HCP-patient-family. We include additional resources such as those from the National Association of Pediatric Nurse Practitioners, American Psychological Association Office on Children Youth and Families, the Office of Ethnic Minority Affairs, the Office on Socioeconomic Status, and American Academy of Pediatrics to consider in support of equity in healthcare practice of children and their families.
一些有色人种患者及其家庭,包括亚裔美国人,由于生活在白人主导的社会中,面临着重大的不良压力源。仇外心理和种族主义会影响健康。研究证据表明,早年接触诸如种族歧视等不良童年经历是有害的,会对身心健康产生重大的短期和长期影响。这篇评论文章的目的是阐明,当仇外心理和种族主义问题出现时,患者及其家庭可能需要向医疗服务提供者表达他们的担忧和恐惧。患者和家庭在医疗环境中需要有空间来感到被倾听和理解。在医疗服务不足的亚裔美国人中,反亚裔的仇外心理和种族主义持续存在,并且在新冠疫情期间有所加剧。我们阐述了批判种族理论和亚裔批判理论的原则,并以此视角来理解一个实际案例,即一个反例,讲述了一位越南母亲及其越华裔美国家庭在社区娱乐中心遭遇仇外心理和种族主义的经历,以及随后与医疗服务提供者交流这段经历的过程。我们描述了这些寻求治疗经历的影响,包括医疗服务提供者与患者家庭关系的中断。患者和家庭向医疗服务提供者讲述他们遭受仇外心理和种族主义的故事需要勇气。由于反亚裔的仇外心理以及对白人脆弱性的担忧,一些亚裔美国人不敢寻求医疗保健。接下来,我们强调关于隐性偏见(也称为无意识偏见)的研究证据,以此作为其在一般医疗专业人员中持续广泛存在的背景信息,以及在医疗保健中解决这一问题的必要性。隐性偏见会影响对患者家庭提供的护理以及医疗服务提供者与患者家庭之间的互动。我们还提供了其他资源,比如来自国家儿科护士从业者协会、美国心理学会儿童青少年与家庭办公室、少数族裔事务办公室、社会经济地位办公室以及美国儿科学会的资源,以供参考,以支持儿童及其家庭在医疗保健实践中的公平性。