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通过批判种族理论视角理解肿瘤学中以患者为中心的护理(PCC)的种族-民族差异:对黑种人、西班牙裔和白种癌症患者的 PCC 进行定性比较。

Understanding racial-ethnic differences in patient-centered care (PCC) in oncology through a critical race theory lens: A qualitative comparison of PCC among Black, Hispanic, and White cancer patients.

机构信息

Public Health Program, Austin College, Sherman, TX, USA.

Pack Health, Birmingham, AL, USA.

出版信息

Patient Educ Couns. 2022 Jul;105(7):2346-2354. doi: 10.1016/j.pec.2021.11.011. Epub 2021 Nov 19.

Abstract

OBJECTIVES

Patient-centered care (PCC) experiences can vary by race and ethnicity and likely contribute to cancer care disparities. We compared PCC concepts between Non-Hispanic White (White), Hispanic, and Non-Hispanic Black (Black) cancer patients utilizing Critical Race Theory (CRT) to understand the relationships between racial-ethnic identity and PCC.

METHODS

A thematic analysis and in-depth CRT-informed analysis of individual interviews exploring patient values, unmet needs, preferences, and priorities were performed.

RESULTS

Participants were aged> 25 yrs old, 53% male, and included 5 Hispanic, 4 Black and 6 White cancer patients. Unmet needs for time to make decisions, and provider interaction between visits and the value for finding meaning in the illness emerged among Blacks and Whites. The unmet need for a long-term treatment plan emerged among Blacks, and the preference of research participation among Whites. A value for optimism was observed among Hispanics and Whites. Racial-ethnic variations in patient descriptions and experiences of their values, unmet needs, preferences, and priorities were identified.

CONCLUSIONS

Underrepresented groups face subtle but significant challenges in feeling cared for and understood, voicing concerns, and obtaining quality care.

PRACTICE IMPLICATIONS

Increased mutual understanding and provider knowledge of unique PCC experiences among underrepresented cancer patients are needed.

摘要

目的

以患者为中心的护理(PCC)体验因种族和民族而异,可能导致癌症护理的差异。我们利用批判种族理论(CRT)比较了非西班牙裔白人(白人)、西班牙裔和非西班牙裔黑人(黑人)癌症患者的 PCC 概念,以了解种族认同与 PCC 之间的关系。

方法

对探讨患者价值观、未满足需求、偏好和优先级的个体访谈进行主题分析和深入的 CRT 知情分析。

结果

参与者年龄> 25 岁,男性占 53%,包括 5 名西班牙裔、4 名黑人和 6 名白种人癌症患者。黑人和白种人都出现了对决策时间和就诊期间医生互动的需求未得到满足,以及对在疾病中寻找意义的重视。黑种人出现了对长期治疗计划的需求未得到满足,白种人出现了对参与研究的偏好。西班牙裔和白种人都表现出对乐观的重视。确定了患者对其价值观、未满足需求、偏好和优先级的描述和体验的种族和民族差异。

结论

代表性不足的群体在感到被关心和理解、表达关切以及获得优质护理方面面临微妙但重大的挑战。

实践意义

需要增加对代表性不足的癌症患者独特 PCC 体验的相互理解和提供者的了解。

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