Department of Pediatrics, Duke University Hospital, Durham, North Carolina.
Departments of Biostatistics and Bioinformatics.
Hosp Pediatr. 2022 Feb 1;12(2):e72-e77. doi: 10.1542/hpeds.2021-006034.
Despite widespread adoption of family-centered rounds, few have investigated differences in the experience of family-centered rounds by family race and ethnicity. The purpose of this study was to explore racial and ethnic differences in caregiver perception of inclusion and empowerment during family-centered rounds.
We identified eligible caregivers of children admitted to the general pediatrics team through the electronic health record. Surveys were completed by 99 caregivers (47 non-Latinx White and 52 Black, Latinx, or other caregivers of color). To compare agreement with statements of inclusivity and empowerment, we used the Wilcoxon rank sum test in unadjusted analyses and linear regression for the adjusted analyses.
Most (91%) caregivers were satisfied or extremely satisfied with family-centered rounds. We found no differences by race or ethnicity in statements of satisfaction or understanding family-centered rounds content. However, in both unadjusted and adjusted analyses, we found that White caregivers more strongly agreed with the statements "I felt comfortable participating in rounds," "I had adequate time to ask questions during rounds," and "I felt a valued member of the team during rounds" compared with Black, Latinx, and other caregivers of color.
Congruent with studies of communication in other settings, caregivers of color may experience barriers to inclusion in family-centered rounds, such as medical team bias, less empathic communication, and shorter encounters. Future studies are needed to better understand family-centered rounds disparities and develop interventions that promote inclusive rounds.
尽管以家庭为中心的查房已经得到广泛应用,但很少有研究调查家庭种族和民族差异对以家庭为中心的查房体验的影响。本研究旨在探讨在以家庭为中心的查房过程中,护理人员对包容性和赋权感知的种族和民族差异。
我们通过电子病历确定了普通儿科团队入院患儿的合格护理人员。共有 99 位护理人员(47 位非拉丁裔白人,52 位黑人、拉丁裔或其他有色人种护理人员)完成了调查。为了比较对包容性和赋权的陈述的一致性,我们在未调整分析中使用 Wilcoxon 秩和检验,在调整分析中使用线性回归。
大多数(91%)护理人员对以家庭为中心的查房感到满意或非常满意。我们没有发现种族或民族差异与对以家庭为中心的查房内容的满意度或理解程度相关。然而,在未调整和调整分析中,我们发现与黑人、拉丁裔和其他有色人种护理人员相比,白人护理人员更强烈地认同以下陈述:“我觉得在查房中很自在”、“我有足够的时间在查房中提问”和“我觉得自己是团队中的有价值成员”。
与其他环境中的沟通研究一致,有色人种护理人员在以家庭为中心的查房中可能会遇到包容性障碍,例如医疗团队的偏见、缺乏同理心的沟通和较短的接触时间。未来需要进一步研究以更好地了解以家庭为中心的查房差异,并制定促进包容性查房的干预措施。