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新冠疫情期间的恐惧、孤立与不被关注:对美国密歇根州东南部边缘化社区成年残疾人士的定性研究

Fear, Isolation, and Invisibility during the COVID-19 Pandemic: A Qualitative Study of Adults with Physical Disabilities in Marginalized Communities in Southeastern Michigan in the United States.

作者信息

Reber Lisa, Kreschmer Jodi M, DeShong Gina L, Meade Michelle A

机构信息

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA.

The Disability Network, Flint, MI 48507, USA.

出版信息

Disabilities (Basel). 2021;2. doi: 10.3390/disabilities2010010.

Abstract

This study examines the initial impact of the COVID-19 pandemic on adults with physical disabilities from marginalized communities in southeastern Michigan, one of the early pandemic epicenters in the United States. A purposeful sample of fifteen adults with moderate to severe physical disabilities were recruited, taking part in individual remote semi-structured qualitative interviews, which were recorded, transcribed, and coded for emergent themes using a thematic approach to coding and analysis. Three interrelated, overarching themes emerged: fear, feelings of isolation, and a sense of being invisible. These were identified in the contexts of health and healthcare, home care assistance, and access to resources. The findings help illuminate the experiences of those from socioeconomically and racially marginalized communities, populations that are often "always already" vulnerable. Participant narratives made visible the negative impact of the pandemic on physical and mental health as well as the lack of accommodations available. They showed that participants were faced with a dilemma between engaging in risky behavior to have their needs met or avoiding risk and not have those needs met. This knowledge can expand awareness and appreciation of how social, economic, and political systems impact adults with physical disabilities in lower-income and racially diverse communities and provide guidance in designing future clinical and emergency response policies.

摘要

本研究考察了新冠疫情对密歇根州东南部边缘化社区中成年身体残疾者的初步影响,该地区是美国早期的疫情中心之一。我们招募了15名有中度至重度身体残疾的成年人作为有目的抽样,他们参与了单独的远程半结构化定性访谈,访谈进行了录音、转录,并采用主题编码和分析方法对浮现的主题进行编码。出现了三个相互关联的总体主题:恐惧、孤独感和被忽视感。这些主题是在健康与医疗保健、家庭护理援助以及资源获取的背景下被识别出来的。研究结果有助于阐明社会经济和种族边缘化社区人群的经历,这些人群往往“一直以来”就很脆弱。参与者的叙述揭示了疫情对身心健康的负面影响以及可用便利设施的匮乏。这些叙述表明,参与者面临着一个两难困境:是采取危险行为来满足自身需求,还是规避风险而无法满足这些需求。这些认识能够扩大人们对于社会、经济和政治系统如何影响低收入和种族多元化社区中成年身体残疾者的认识和理解,并为未来临床及应急响应政策的制定提供指导。

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