College of Medicine, The Ohio State University, Columbus, OH, USA.
Department of Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, Houston, TX, USA.
J Racial Ethn Health Disparities. 2024 Apr;11(2):992-1004. doi: 10.1007/s40615-023-01579-5. Epub 2023 Apr 3.
Black patients are at a higher risk of experiencing less safe and lower quality care during pregnancy and childbirth, compared to their White counterparts. Behaviors that healthcare professionals engage in that can facilitate or hinder high-quality care for this population are underexplored. We sought to explore Black patients' experiences with healthcare professionals during and after pregnancy, as a needs assessment to inform the development of training for healthcare professionals.
We conducted semi-structured interviews of Black patients who were in their third trimester of pregnancy or within 18 months of giving birth. Questions focused on experiences with healthcare professionals during pregnancy-related healthcare, including quality of care and discrimination. Thematic analysis was conducted using a combined deductive-inductive approach. Findings were considered in the context of the Institute of Medicine's Six Domains of Quality (equitable, patient-centered, timely, safe, effective, efficient).
We interviewed 8 participants who received care from various clinics and institutions. Over half (62%) described experiencing discrimination or microaggressions during their pregnancy-related healthcare. Participants most commonly reflected upon experiences within the patient-centered care domain, regarding whether care was in alignment with their preferences, positive and negative interpersonal interactions, and varied experiences with patient education/shared decision-making.
Black patients commonly report experiencing discrimination from healthcare professionals during pregnancy-related healthcare. Reducing microaggressions and improving patient-centered care is a key focus for healthcare professionals who serve this group. Training needs include addressing implicit bias, educating on common microaggressions, improving communication, and promoting an inclusive workplace.
与白人患者相比，黑人群体在妊娠和分娩期间更有可能经历安全性较低、质量较差的医疗护理。医疗保健专业人员在促进或阻碍为这一人群提供高质量护理方面的行为尚未得到充分探索。我们旨在探索黑人群体在妊娠期间及之后与医疗保健专业人员的互动经历，以此作为需求评估，为医疗保健专业人员培训的制定提供信息。
我们对处于妊娠晚期或分娩后 18 个月内的黑人患者进行了半结构化访谈。问题集中在与妊娠相关的医疗保健期间与医疗保健专业人员的互动经历，包括护理质量和歧视。使用综合演绎法进行主题分析。研究结果考虑了医学研究所的六个质量领域（公平、以患者为中心、及时、安全、有效、高效）的背景。
我们采访了 8 名在不同诊所和机构接受护理的参与者。超过一半（62%）的人在妊娠相关医疗保健中描述了经历歧视或微侵犯的情况。参与者最常反映以患者为中心的护理领域的经历，包括护理是否符合他们的偏好、积极和消极的人际互动，以及患者教育/共同决策方面的不同经历。
黑人群体在妊娠相关医疗保健中经常报告经历医疗保健专业人员的歧视。减少微侵犯和改善以患者为中心的护理是服务这一群体的医疗保健专业人员的重点关注领域。培训需求包括解决内隐偏见、教育常见的微侵犯、改善沟通和促进包容的工作场所。
