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专科姑息治疗服务对感染新冠病毒的少数族裔群体的应对:平等却不公平——一项观察性研究

Specialist palliative care services response to ethnic minority groups with COVID-19: equal but inequitable-an observational study.

作者信息

Bajwah Sabrina, Koffman Jonathan, Hussain Jamilla, Bradshaw Andy, Hocaoglu Mevhibe B, Fraser Lorna K, Oluyase Adejoke, Allwin Caitlin, Dunleavy Lesley, Preston Nancy, Cripps Rachel, Maddocks Matthew, Sleeman Katherine E, Higginson Irene J, Walshe Catherine, Murtagh Fliss E M

机构信息

Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK

Department of Palliative Care, King's College Hospital NHS Foundation Trust, London, UK.

出版信息

BMJ Support Palliat Care. 2021 Sep 12. doi: 10.1136/bmjspcare-2021-003083.

Abstract

OBJECTIVES

To develop insights into response of palliative care services caring for people from ethnic minority groups during COVID-19.

METHODS

Cross-sectional online survey of UK palliative care services response to COVID-19. Quantitative data were summarised descriptively and χ tests used to explore relationships between categorical variables. Free text comments were analysed using reflexive thematic analysis.

RESULTS

277 UK services responded. 168 included hospice teams (76% of all UK hospice teams). Services supporting those from ethnic minority groups were more likely to include hospital (p<0.001) and less likely to include hospice (p<0.001) or home care teams (p=0.008). 34% (93/277) of services had cared for patients with COVID-19 or families from ethnic minority groups. 66% (61/93) of these services stated no difference in how they supported or reached these groups during the pandemic.Three themes demonstrated impact of policy introduced during the pandemic, including: disproportionate adverse impact of restricted visiting, compounded communication challenges and unmet religious and faith needs. One theme demonstrated mistrust of services by ethnic minority groups, and the final theme demonstrated a focus on equal and individualised care.

CONCLUSIONS

Policies introduced during the COVID-19 pandemic may have adversely impacted those from ethnic minority groups making these at-risk populations even more vulnerable. The palliative care response may have been equal but inequitable. During the para-COVID-19 period, systemic steps, including equality impact assessments, are urgently needed.

摘要

目标

深入了解新冠疫情期间姑息治疗服务机构对少数族裔人群的应对情况。

方法

对英国姑息治疗服务机构应对新冠疫情进行横断面在线调查。定量数据采用描述性方法进行总结,χ检验用于探索分类变量之间的关系。自由文本评论采用反思性主题分析进行分析。

结果

277家英国服务机构做出回应。其中168家包括临终关怀团队(占英国所有临终关怀团队的76%)。为少数族裔人群提供支持的服务机构更有可能包括医院(p<0.001),而包括临终关怀机构(p<0.001)或居家护理团队的可能性较小(p=0.008)。34%(93/277)的服务机构曾为感染新冠病毒的患者或少数族裔家庭提供护理。其中66%(61/93)的服务机构表示,在疫情期间,他们为这些群体提供支持或与之接触的方式没有差异。三个主题展示了疫情期间出台的政策的影响,包括:探访受限带来的不成比例的不利影响、加剧的沟通挑战以及未得到满足的宗教和信仰需求。一个主题展示了少数族裔群体对服务机构的不信任,最后一个主题展示了对平等和个性化护理的关注。

结论

新冠疫情期间出台的政策可能对少数族裔人群产生了不利影响,使这些高危人群更加脆弱。姑息治疗的应对措施可能是平等的,但却是不公平的。在新冠疫情后时期,迫切需要采取系统性措施,包括平等影响评估。

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