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医疗保健行业中的残疾歧视:对残疾医疗保健提供者所遭受的歧视的经历和影响的系统评价。

Ableism within health care professions: a systematic review of the experiences and impact of discrimination against health care providers with disabilities.

机构信息

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.

Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.

出版信息

Disabil Rehabil. 2023 Aug;45(17):2715-2731. doi: 10.1080/09638288.2022.2107086. Epub 2022 Aug 8.

Abstract

PURPOSE

People with disabilities experience concerning rates of ableism and are significantly under-represented within healthcare education and professions. Focusing on healthcare professions is important for enhancing the diversity and inclusion of equity-deserving groups within the workforce. The objective of this review was to explore the experiences and impact of workplace discrimination and ableism among healthcare providers and trainees with disabilities.

METHODS

Systematic searches of seven databases from 2000 to January 2022 were conducted. Five reviewers independently applied the inclusion criteria, extracted the data and rated the study quality.

RESULTS

48 studies met our inclusion criteria, representing 13,815 participants across six countries over a 21-year period. The findings highlighted rates and types of workplace ableism, which occurred at the institutional (i.e., inaccessible environments, physical barriers and unsupportive work environments) and individual level (i.e., negative attitudes, bullying, harassment). The impact of ableism on healthcare providers included difficulty disclosing due to fear of stigma, and effects on well-being and career development.

CONCLUSIONS

Our findings revealed a critical need for more research on the experiences of ableism amongst healthcare providers and the impact it has on their well-being. Further efforts should explore mechanisms for including and welcoming people with disabilities in healthcare professions.Implications for rehabilitationWorkplace ableism is prevalent in health care professions and could be discouraging people with disabilities from entering or completing health care education and training, leading to an under-representation of this equity-deserving group within health care.More efforts are needed to recruit, retain and support people with disabilities in the health care workforce.Health care providers who have a disability often experience workplace discrimination and inaccessible physical environments which can impact their health and well-being.Managers, senior leadership and health care organizations should advocate for improved social inclusion of employees with disabilities.

摘要

目的

残疾人经历着令人担忧的歧视,在医疗保健教育和职业中代表性严重不足。关注医疗保健职业对于增强劳动力中公平权益群体的多样性和包容性非常重要。本研究的目的是探讨残疾医疗保健提供者和受训者在工作场所中面临的歧视和残疾歧视的经历和影响。

方法

从 2000 年到 2022 年 1 月,对七个数据库进行了系统搜索。五名审查员独立应用纳入标准、提取数据并评估研究质量。

结果

48 项研究符合我们的纳入标准,代表了六个国家在 21 年期间的 13815 名参与者。研究结果强调了工作场所中的残疾歧视的发生率和类型,包括机构层面(即,无障碍环境、物理障碍和不支持的工作环境)和个人层面(即,负面态度、欺凌、骚扰)。残疾歧视对医疗保健提供者的影响包括由于害怕污名化而难以披露,以及对幸福感和职业发展的影响。

结论

我们的研究结果表明,需要更多研究残疾歧视在医疗保健提供者中的经历及其对他们福祉的影响。进一步的努力应该探索包括和欢迎残疾人士进入医疗保健职业的机制。

康复意义

工作场所残疾歧视在医疗保健职业中普遍存在,可能会阻止残疾人进入或完成医疗保健教育和培训,导致这个公平权益群体在医疗保健中的代表性不足。需要更多的努力来招聘、留住和支持医疗保健劳动力中的残疾人士。有残疾的医疗保健提供者经常经历工作场所歧视和无障碍的物理环境,这可能会影响他们的健康和福祉。管理者、高级领导层和医疗保健组织应倡导改善残疾员工的社会包容度。

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