Bogdan-Lovis Elizabeth, Zhuang Jie, Goldbort Joanne, Shareef Sameerah, Bresnahan Mary, Kelly-Blake Karen, Elam Kendra
College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Communication Studies, Texas Christian University, Fort Worth, Texas, USA.
Birth. 2023 Jun;50(2):310-318. doi: 10.1111/birt.12657. Epub 2022 May 30.
For many years in the United States, there has been an active discussion about whether race concordance between care providers and patients contributes to better health outcomes. Although beneficial provider-patient communication effects have been associated with concordance, there is minimal evidence for concordance benefits to health outcomes.
A cross-sectional survey was conducted including 200 Black mothers who had given birth within the last 2 years asking about the perceived racial identity of their birth health provider, whether they preferred to have Black women providers, and the intersection between race and gender concordance on birth outcomes. In addition to race and gender concordance, other variables were tested for their impact on birth satisfaction including respect, trust for the care provider, perceived competence, care provider empathy, and inclusive communication.
Forty-one percent of the mothers in this study were assisted in birth by a Black woman provider. Although patient-provider concordance did not result in measurable health outcomes, it is clear that compared to other studies of birth satisfaction among Black birthing persons, this study showed relatively higher levels of satisfaction, perceived trust, empathy, perceived provider competence, inclusive communication, and equal respect for both concordant and discordant care providers.
Although many participants showed a preference for race concordance, participants equally valued respect, competence, and trust with their care providers. Further community-based research needs to be conducted to examine whether race, gender, and cultural concordance results in other beneficial health outcomes.
多年来，在美国一直存在关于医疗服务提供者与患者之间的种族匹配是否有助于实现更好的健康结果的积极讨论。尽管有益的医患沟通效果与匹配度有关，但几乎没有证据表明匹配度对健康结果有益。
开展了一项横断面调查，纳入了200名在过去两年内分娩的黑人母亲，询问她们对分娩健康服务提供者的种族认知、她们是否希望由黑人女性提供服务，以及种族和性别匹配度与分娩结局之间的交叉关系。除了种族和性别匹配度外，还测试了其他变量对分娩满意度的影响，包括尊重、对医疗服务提供者的信任、感知到的能力、医疗服务提供者的同理心以及包容性沟通。
本研究中41%的母亲在分娩时由黑人女性医疗服务提供者协助。尽管医患匹配度并未带来可衡量的健康结果，但显然，与其他关于黑人分娩者分娩满意度的研究相比，本研究显示出相对较高的满意度、感知到的信任、同理心、感知到的医疗服务提供者能力、包容性沟通以及对匹配和不匹配的医疗服务提供者的平等尊重。
尽管许多参与者表现出对种族匹配的偏好，但参与者同样重视对医疗服务提供者的尊重、能力和信任。需要开展进一步的基于社区的研究，以检验种族、性别和文化匹配是否会带来其他有益的健康结果。
