医疗保健中的种族主义：范围综述。
Racism in healthcare: a scoping review.
机构信息
Department of Sociology, Uppsala University, Uppsala, Sweden.
Skaraborg Institute for Research and Development, Skövde, Sweden.
出版信息
BMC Public Health. 2022 May 16;22(1):988. doi: 10.1186/s12889-022-13122-y.
BACKGROUND
Racism constitutes a barrier towards achieving equitable healthcare as documented in research showing unequal processes of delivering, accessing, and receiving healthcare across countries and healthcare indicators. This review summarizes studies examining how racism is discussed and produced in the process of delivering, accessing and receiving healthcare across various national contexts.
METHOD
The PRISMA guidelines for scoping reviews were followed and databases were searched for peer reviewed empirical articles in English across national contexts. No starting date limitation was applied for this review. The end date was December 1, 2020. The review scoped 213 articles. The results were summarized, coded and thematically categorized in regards to the aim.
RESULTS
The review yielded the following categories: healthcare users' experiences of racism in healthcare; healthcare staff's experiences of racism; healthcare staff's racial attitudes and beliefs; effects of racism in healthcare on various treatment choices; healthcare staff's reflections on racism in healthcare and; antiracist training in healthcare. Racialized minorities experience inadequate healthcare and being dismissed in healthcare interactions. Experiences of racism are associated with lack of trust and delay in seeking healthcare. Racialized minority healthcare staff experience racism in their workplace from healthcare users and colleagues and lack of organizational support in managing racism. Research on healthcare staff's racial attitudes and beliefs demonstrate a range of negative stereotypes regarding racialized minority healthcare users who are viewed as difficult. Research on implicit racial bias illustrates that healthcare staff exhibit racial bias in favor of majority group. Healthcare staff's racial bias may influence medical decisions negatively. Studies examining healthcare staff's reflections on racism and antiracist training show that healthcare staff tend to construct healthcare as impartial and that healthcare staff do not readily discuss racism in their workplace.
CONCLUSIONS
The USA dominates the research. It is imperative that research covers other geo-political contexts. Research on racism in healthcare is mainly descriptive, atheoretical, uses racial categories uncritically and tends to ignore racialization processes making it difficult to conceptualize racism. Sociological research on racism could inform research on racism as it theoretically explains racism's structural embeddedness, which could aid in tackling racism to provide good quality care.
背景
种族主义是实现公平医疗保健的障碍，这在研究中得到了证实，这些研究表明，在国家和医疗保健指标层面上，医疗保健的提供、获得和接受过程存在不平等。本综述总结了研究如何在不同的国家背景下讨论和产生在医疗保健的提供、获得和接受过程中的种族主义。
方法
本综述遵循 PRISMA 指南进行，在英语国家背景下对同行评审的实证文章进行了数据库搜索。本综述没有设定起始日期的限制。截止日期为 2020 年 12 月 1 日。综述共纳入 213 篇文章。根据目的对结果进行了总结、编码和主题分类。
结果
综述结果包括以下几类：医疗保健用户在医疗保健中经历的种族主义；医疗保健工作人员经历的种族主义；医疗保健工作人员的种族态度和信念；医疗保健中的种族主义对各种治疗选择的影响；医疗保健工作人员对医疗保健中的种族主义的反思；医疗保健中的反种族主义培训。种族化少数群体在医疗保健中经历不足，并在医疗保健互动中被忽视。种族主义的经历与缺乏信任和延迟寻求医疗保健有关。种族化少数族裔医疗保健工作者在工作场所受到医疗保健用户和同事的种族主义，并且在管理种族主义方面缺乏组织支持。关于医疗保健工作人员种族态度和信念的研究表明，他们对种族化少数族裔医疗保健用户存在一系列负面刻板印象，认为他们难以相处。关于隐性种族偏见的研究表明，医疗保健工作人员在医疗保健中表现出对多数群体的种族偏见。医疗保健工作人员的种族偏见可能会对医疗决策产生负面影响。研究医疗保健工作人员对种族主义的反思和反种族主义培训表明，医疗保健工作人员倾向于将医疗保健视为公正的，并且他们不愿意在工作场所讨论种族主义。
结论
美国主导着这项研究。至关重要的是，研究应涵盖其他地缘政治背景。医疗保健中的种族主义研究主要是描述性的、无理论的，批判性地使用种族类别，并且往往忽视种族化过程，这使得概念化种族主义变得困难。社会学对种族主义的研究可以为种族主义研究提供信息，因为它从理论上解释了种族主义的结构性嵌入性，这有助于解决种族主义问题，提供高质量的护理。
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