Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
Pediatr Res. 2023 May;93(6):1672-1678. doi: 10.1038/s41390-022-02217-2. Epub 2022 Aug 29.
Inequity in neonatology may be potentiated within neonatal intensive care units (NICUs) by the effects of bias. Addressing bias can lead to improved, more equitable care. Understanding perceptions of bias can inform targeted interventions to reduce the impact of bias. We conducted a mixed methods study to characterize the perceptions of bias among NICU staff.
Surveys were distributed to all staff (N = 245) in a single academic Level IV NICU. Respondents rated the impact of bias on their own and others' behaviors on 5-point Likert scales and answered one open-ended question. Kruskal-Wallis test (KWT) and Levene's test were used for quantitative analysis and thematic analysis was used for qualitative analysis.
We received 178 responses. More respondents agreed that bias had a greater impact on others' vs. their own behaviors (KWT p < 0.05). Respondents agreed that behaviors were influenced more by implicit than explicit biases (KWT p < 0.05). Qualitative analysis resulted in nine unique themes.
Staff perceive a high impact of bias across different domains with increased perceived impact of implicit vs. explicit bias. Staff perceive a greater impact of others' biases vs. their own. Mixed methods studies can help identify unique, unit-responsive approaches to reduce bias.
Healthcare staff have awareness of bias and its impact on their behaviors with patients, families, and staff. Healthcare staff believe that implicit bias impacts their behaviors more than explicit bias, and that they have less bias than others. Healthcare staff have ideas for strategies and approaches to mitigate the impact of bias. Mixed method studies are effective ways of understanding environment-specific perceptions of bias, and contextual assets and barriers when creating interventions to reduce bias and improve equity. Generating interventions to reduce the impact of bias in healthcare requires a context-specific understanding of perceptions of bias among staff.
在新生儿重症监护病房（NICU）中，偏见的影响可能会加剧新生儿学中的不平等现象。解决偏见问题可以带来更优质、更公平的护理。了解偏见的看法可以为有针对性的干预措施提供信息，以减少偏见的影响。我们进行了一项混合方法研究，以描述 NICU 工作人员对偏见的看法。
我们向一家学术四级 NICU 的所有工作人员（N=245）分发了调查。受访者在 5 分制的李克特量表上对偏见对他们自己和他人行为的影响进行评分，并回答了一个开放式问题。我们使用 Kruskal-Wallis 检验（KWT）和 Levene 检验进行定量分析，使用主题分析进行定性分析。
我们收到了 178 份回复。更多的受访者认为偏见对他人的行为比对自己的行为影响更大（KWT p<0.05）。受访者认为行为受到隐性偏见的影响大于显性偏见（KWT p<0.05）。定性分析产生了九个独特的主题。
工作人员认为不同领域的偏见有很大的影响，与显性偏见相比，他们认为隐性偏见的影响更大。工作人员认为他人的偏见对他们的影响比自己的偏见更大。混合方法研究可以帮助确定针对不同单位的独特方法来减少偏见。
医疗保健人员对偏见及其对患者、家属和工作人员行为的影响有一定的认识。医疗保健人员认为隐性偏见比显性偏见更能影响他们的行为，而且他们认为自己的偏见比别人的偏见少。医疗保健人员对减轻偏见影响的策略和方法有自己的想法。混合方法研究是了解特定环境中工作人员对偏见的看法以及在制定减少偏见和提高公平性的干预措施时的背景资产和障碍的有效方法。减少医疗保健中偏见影响的干预措施需要对工作人员的偏见看法有特定于背景的理解。
