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具有文化敏感性和包容性的炎症性肠病护理。

Culturally Sensitive and Inclusive IBD Care.

作者信息

Chedid Victor, Targownik Laura, Damas Oriana M, Balzora Sophie

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.

Division of Gastroenterology and Hepatology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada.

出版信息

Clin Gastroenterol Hepatol. 2025 Feb;23(3):440-453. doi: 10.1016/j.cgh.2024.06.052. Epub 2024 Sep 23.

Abstract

As the prevalence of inflammatory bowel disease (IBD) increases within historically disadvantaged communities, it is imperative to better understand how intersectionality-defined as the complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism)-intersects and social determinants of health influence the patient's experiences within the medical system when navigating their disease. Culturally sensitive care is characterized by the ability to deliver patient-centered care that recognizes how the intersectionality of an individual's identities impacts their disease journey. An intentional consideration and sensitivity to this impact play important roles in providing an inclusive and welcoming space for historically disadvantaged individuals living with IBD and will help address health inequity in IBD. Cultural competence implies mastery of care that understands and respects values and beliefs across cultures, while cultural humility involves recognizing the complexity of cultural identity and engaging in an ongoing learning process from individual patient experiences. Heightening our patient care goals from cultural competence to cultural sensitivity allows healthcare professionals and the systems in which they practice to lead with cultural humility as they adopt a more inclusive and humble perspective when caring for patient groups with a diverse array of identities and cultures and to avoid maintaining the status quo of implicit and explicit biases that impede the delivery of quality IBD care. In this article, we review the literature on IBD care in historically disadvantaged communities, address culturally sensitive care, and propose a framework to incorporating cultural humility in IBD practices and research.

摘要

随着炎症性肠病(IBD)在历史上处于弱势地位的社区中的患病率上升,当这些患者在应对疾病时,必须更好地理解交叉性(定义为多种形式的歧视,如种族主义、性别歧视和阶级歧视的影响相互交织的复杂累积方式)与健康的社会决定因素如何影响患者在医疗系统中的就医体验。具有文化敏感性的护理的特点是能够提供以患者为中心的护理,认识到个人身份的交叉性如何影响他们的疾病历程。有意考虑并敏感对待这种影响,对于为历史上处于弱势地位的IBD患者提供一个包容和友好的空间起着重要作用,并将有助于解决IBD中的健康不平等问题。文化能力意味着掌握理解和尊重不同文化的价值观和信仰的护理方法,而文化谦逊则涉及认识到文化身份的复杂性,并从个体患者的经历中持续学习。将我们的患者护理目标从文化能力提升到文化敏感性,使医疗保健专业人员及其执业的系统能够以文化谦逊为引领,在照顾具有不同身份和文化的患者群体时,采用更具包容性和谦逊的视角,避免维持阻碍提供高质量IBD护理的隐性和显性偏见的现状。在本文中,我们回顾了关于历史上处于弱势地位社区中IBD护理的文献,探讨了具有文化敏感性的护理,并提出了一个在IBD实践和研究中纳入文化谦逊的框架。

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