Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241290888. doi: 10.1177/21501319241290888.
Equity-deserving groups (EDGs) face societal barriers, including healthcare barriers within the emergency department (ED), due to discrimination. Most patient-care experience research considers only a single-axis perspective, neglecting multifaceted impacts of discrimination, or intersectionality.
Detailed is a secondary analysis of a mixed-methods, cross-sectional study conducted at the Kingston Health Sciences Centre (KHSC) between June and August 2021. A quantitative analysis was conducted to identify differences between participants who did not identify as equity-deserving (controls), and those who identified with 1, 2, or 3 EDGs, respectively. The research team conducted thematic analysis on the shared micronarratives to contextualize the quantitative results. The research team also held focus groups with community partners that served EDGs to gain their insights on study findings and add their perspectives to the captured themes.
Comparing 1973 individuals belonging to none, 1, 2, or 3 EDGs revealed significant differences in patient-perceived attention to their needs ( < .001), patient-control in health care decision-making ( = .001), and whether quality medical care or experiencing kindness/respect was more important ( = .003). Three themes were identified: , , and .
The study's findings contribute to a sparse body of evidence on EDG-care experiences in the ED through an intersectionality lens. Future research efforts should evaluate the complex interactions of specific EDG memberships to improve care experiences.
由于歧视，权益受损群体（EDG）在急诊部门（ED）面临社会障碍，包括医疗保健障碍。大多数患者护理体验研究仅考虑单一轴的观点，忽略了歧视或交叉性的多方面影响。
详细介绍了 2021 年 6 月至 8 月在金士顿健康科学中心（KHSC）进行的一项混合方法、横断面研究的二次分析。进行了定量分析，以确定未被认定为权益受损者（对照组）的参与者与分别认定为 1、2 或 3 个 EDG 的参与者之间的差异。研究团队对共享的微观叙事进行了主题分析，以将定量结果置于上下文中。研究团队还与服务于 EDG 的社区合作伙伴举行了焦点小组会议，以了解他们对研究结果的看法，并将他们的观点添加到所捕获的主题中。
比较属于无、1、2 或 3 个 EDG 的 1973 个人，发现患者对自身需求的关注度（ < .001）、患者在医疗保健决策中的控制感（ = .001）以及医疗质量或体验到善意/尊重哪个更重要（ = .003）方面存在显著差异。确定了三个主题： 、 、 。
该研究通过交叉性视角为 EDG 在 ED 中的护理体验这一稀缺证据做出了贡献。未来的研究工作应评估特定 EDG 成员身份的复杂相互作用，以改善护理体验。
