Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, South Holland, 3015 GD, The Netherlands.
Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital, Campus Entrance 42, C. Heymanslaan 10, Ghent, 9000, Belgium.
Int J Equity Health. 2024 Jun 5;23(1):117. doi: 10.1186/s12939-024-02189-1.
The provision of diversity-sensitive care is a promising approach towards reducing health disparities. Recent criticism and a scientific gap demonstrate the need for the patient perspective on diversity-sensitive care. This systematic review aims to describe the patient perspective, including patient experiences, expectations, and satisfaction with diversity-sensitive care provided by healthcare providers.
In December 2022 the Medline ALL, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO and additionally Google Scholar were searched for original studies that described or measured patient expectations, experiences, and/or satisfaction, specifically focusing on cultural or diversity competence of healthcare providers. Analysis of the collected data was performed using a convergent mixed-methods design based on thematic synthesis.
From initially 5,387 articles, 117 were selected for full-text screening, and ultimately, 34 articles were included in this study. The concept of diversity-sensitive care was observed to comprise three components. The first component is focused on patient-centered care and includes competencies such as clear and direct communication, shared decision-making, individualized care, empathy, and consideration. The second component centers on providing culturally tailored information, adjusting care to cultural needs, working with interpreters, allyship, community partnerships, self-awareness, and cultural knowledge, and builds upon the first component. Across the first two components of diversity-sensitive care, patients have reported experiencing dissatisfaction and encountering shortcomings in their healthcare providers, sometimes resulting in the third and final component pertaining to provider care. This component underscores the importance of linguistic, ethnic, cultural, and gender concordance in delivering quality care.
In conclusion, the patient perspective on diversity-sensitive care encompasses multiple components, from patient-centered care to concordant care. The components incorporate various competencies as communication skills, empathy, self-awareness and adjusting care to cultural needs. Patients reported experiencing dissatisfaction and shortcomings across all components of diversity-sensitive care provided by healthcare providers.
提供对多样性敏感的护理是减少健康差距的一种有前途的方法。最近的批评和科学空白表明，需要从患者的角度看待对多样性敏感的护理。本系统评价旨在描述患者的观点，包括患者对医疗保健提供者提供的对多样性敏感的护理的体验、期望和满意度。
2022 年 12 月，检索了 Medline ALL、Embase、Web of Science 核心合集、Cochrane 对照试验中心注册库、CINAHL、PsycINFO 以及额外的 Google Scholar，以查找描述或衡量患者期望、体验和/或满意度的原始研究，特别是关注医疗保健提供者的文化或多样性能力。使用基于主题综合的收敛混合方法设计对收集的数据进行分析。
最初有 5387 篇文章，有 117 篇被选入全文筛选，最终有 34 篇文章被纳入本研究。观察到对多样性敏感的护理概念包括三个组成部分。第一部分侧重于以患者为中心的护理，包括清晰直接的沟通、共同决策、个性化护理、同理心和考虑等能力。第二部分围绕提供文化适应性信息、调整护理以满足文化需求、与口译员合作、联盟、社区伙伴关系、自我意识和文化知识展开，并建立在第一部分的基础上。在对多样性敏感的护理的前两个组成部分中，患者报告说在医疗保健提供者那里经历了不满，并遇到了一些不足，有时导致了对多样性敏感的护理的第三个也是最后一个组成部分，即提供者护理。这一部分强调了在提供优质护理时语言、民族、文化和性别一致性的重要性。
总之，患者对多样性敏感的护理的观点包括从以患者为中心的护理到一致的护理的多个组成部分。这些组成部分包含了各种能力，如沟通技巧、同理心、自我意识和调整护理以满足文化需求。患者报告说在医疗保健提供者提供的多样性敏感护理的所有组成部分中都经历了不满和不足。
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