Nathoo Aisha, Gaspari Sierra, Oogarah Gaitree, Kirby Stephen, Purkey Eva, Bartels Susan A, Walker Melanie
Department of Emergency Medicine, Queen's University, Kingston, Canada.
Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada.
Ethn Health. 2025 Jan;30(1):98-119. doi: 10.1080/13557858.2024.2412858. Epub 2024 Oct 12.
Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities.
From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants' interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group.
Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities' ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged.
Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable.
少数族裔在加拿大人口中所占比例日益增加，他们表达了在急诊科接受治疗时遭遇种族主义的担忧。了解少数族裔在急诊科的就医经历对于改善医疗服务和减少健康差距至关重要。
2021年6月至8月，我们采用一种意义建构方法，从安大略省金斯顿的参与者那里收集数据。在过去24个月内曾接受过急诊护理或陪同他人前往急诊科的个人有资格参与。在分享了关于他们就医经历的简短叙述后，参与者通过在各种预先确定的问题上描绘自己的观点来解读这段经历。在此，我们对涉及被认定为少数族裔的患者的叙述进行了主题分析，并用参与者解释性回答的定量分析对其进行补充。这种混合方法突出了少数族裔参与者与对照组相比的独特经历。
在1973名独特的参与者中，117人被认定为少数族裔，949名参与者未被认定为应享有公平待遇的群体（对照组）。少数族裔参与者更有可能报告他们的身份很少受到关注，并且更有可能表达希望在接受最佳医疗护理与得到友善和尊重的对待之间取得平衡。少数族裔在急诊科的经历也更有可能受到急诊工作人员行为的影响。定性分析揭示了他们有不知情和无权的负面感受、面临评判和歧视以及遭遇语言障碍等经历。同时也出现了从工作人员那里获得同情护理的积极经历。
少数族裔对急诊科护理的看法往往是负面的，主要集中在工作人员的对待方式上。文化能力和语言翻译服务是需要改进的关键领域，以使急诊科护理更易于获得且更加公平。
