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医疗保健领域针对黑人的医学煤气灯效应:加拿大黑人女性的经历

Anti-Black Medical Gaslighting in Healthcare: Experiences of Black Women in Canada.

作者信息

Boakye Priscilla N, Prendergast Nadia, Bailey Annette, Sharon McCleod, Bandari Bahareh, Odutayo Awura-Ama, Anane Brown Eugenia

机构信息

Toronto Metropolitan University, Toronto, ON, Canada.

University of Toronto, Toronto, Canada.

出版信息

Can J Nurs Res. 2025 Mar;57(1):59-68. doi: 10.1177/08445621241247865. Epub 2024 Apr 22.

DOI:10.1177/08445621241247865
PMID:38644764
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11967095/
Abstract

BackgroundStereotype about Black people contribute to nurses and healthcare providers gaslighting and dismissing of their health concerns. Despite the popularity of the term medical gaslighting in mainstream literature, few studies have explored the experiences of Black women during pregnancy and childbirth.PurposeThis paper aims to provide an in-depth insight into Black women's experiences of anti-Black medical gaslighting when accessing care during pregnancy and childbirth.MethodsUtilizing qualitative methods, we conducted 24 semi-structured interviews with Black women in the Greater Toronto Area. We used thematic analysis to ground the data analysis and to generate insight into Black women's experiences.ResultsThree overarching themes: 1) Not Being Understood: Privileging of Medical Knowledge Contributing to the Downplaying of Health Concerns, 2) Not Being Believed: Stereotypes Contributing to Dismissive Healthcare Encounters and 3) Listen to Us: Turning off the Cycle of Medical Gaslighting. These themes highlight ways anti-Black medical gaslighting manifests in Black women's healthcare encounters to create differential access to treatment and care.ConclusionsAnti-Black medical gaslighting contributes to differential access to treatment and care. Improving equitable access to treatment and care must involve addressing structural and epistemic biases in healthcare and fostering a culture of listening to humanize the experience of illness.

摘要

背景

对黑人的刻板印象导致护士和医疗服务提供者对黑人的健康问题进行煤气灯效应(指通过歪曲、否定等手段让受害者怀疑自己的认知)并不予理会。尽管“医疗煤气灯效应”一词在主流文献中很流行,但很少有研究探讨黑人女性在怀孕和分娩期间的经历。

目的

本文旨在深入了解黑人女性在怀孕和分娩期间接受护理时遭遇反黑人医疗煤气灯效应的经历。

方法

我们采用定性方法,对大多伦多地区的黑人女性进行了24次半结构化访谈。我们使用主题分析来进行数据分析,并深入了解黑人女性的经历。

结果

出现了三个总体主题

1)不被理解:医学知识的特权化导致对健康问题的轻视,2)不被相信:刻板印象导致轻视性的医疗遭遇,3)倾听我们:打破医疗煤气灯效应的循环。这些主题突出了反黑人医疗煤气灯效应在黑人女性医疗遭遇中表现出来的方式,从而造成了获得治疗和护理的差异。

结论

反黑人医疗煤气灯效应导致获得治疗和护理的差异。改善公平获得治疗和护理的机会必须包括解决医疗保健中的结构性和认知偏见,并营造一种倾听的文化,以使疾病体验人性化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88dd/11967095/81a6740bd542/10.1177_08445621241247865-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88dd/11967095/81a6740bd542/10.1177_08445621241247865-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88dd/11967095/81a6740bd542/10.1177_08445621241247865-fig1.jpg

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本文引用的文献

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Nurs Inq. 2024 Jul;31(3):e12638. doi: 10.1111/nin.12638. Epub 2024 Mar 27.
2
Obstetric racism and perceived quality of maternity care in Canada: Voices of Black women.加拿大的产科种族主义和产妇护理质量感知:黑人女性的声音。
Womens Health (Lond). 2023 Jan-Dec;19:17455057231199651. doi: 10.1177/17455057231199651.
3
Turning Down the Flame on Medical Gaslighting.
外阴阴道疾病患者的护理经历与煤气灯效应
JAMA Netw Open. 2025 May 1;8(5):e259486. doi: 10.1001/jamanetworkopen.2025.9486.
拒绝医疗煤气灯效应
J Gen Intern Med. 2023 Nov;38(15):3426-3427. doi: 10.1007/s11606-023-08302-4. Epub 2023 Jul 5.
4
Gaslighting in academic medicine: where anti-Black racism lives.学术医学中的煤气灯效应:反黑人种族主义的藏身之处。
CMAJ. 2022 Oct 31;194(42):E1451-E1454. doi: 10.1503/cmaj.212145.
5
Tackling Implicit Bias in Health Care.应对医疗保健中的隐性偏见。
N Engl J Med. 2022 Jul 14;387(2):105-107. doi: 10.1056/NEJMp2201180. Epub 2022 Jul 9.
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JAMA Netw Open. 2022 Jun 1;5(6):e2216281. doi: 10.1001/jamanetworkopen.2022.16281.
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Obstetric gaslighting and the denial of mothers' realities.产科煤气灯效应与对母亲现实的否认。
Soc Sci Med. 2022 May;301:114938. doi: 10.1016/j.socscimed.2022.114938. Epub 2022 Mar 26.
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Treatment Disparities Among the Black Population and Their Influence on the Equitable Management of Chronic Pain.黑人人群中的治疗差异及其对慢性疼痛公平管理的影响。
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