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肺康复医疗保健专业人员对服务使用者受保护特征的理解与经验:一项定性分析。

Pulmonary rehabilitation healthcare professionals understanding and experiences of the protected characteristics of service users: A qualitative analysis.

作者信息

Drover Holly, Singh Sally J, Orme Mark W, Daynes Enya

机构信息

Department of Respiratory Sciences, University of Leicester, Leicester, UK.

Centre for Exercise and Rehabilitation Science, National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK.

出版信息

Chron Respir Dis. 2025 Jan-Dec;22:14799731241307253. doi: 10.1177/14799731241307253.

Abstract

BACKGROUND

Health inequalities can affect access and uptake to pulmonary rehabilitation (PR). An individual's protected characteristics (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation) may contribute to health inequalities. Healthcare professionals (HCPs) experiences of the inclusivity and representativeness of PR services and knowledge of protected characteristics are unknown, however are vital for the identification and resolution of health inequalities. This qualitative study explored HCPs understanding of protected characteristics and their perception of the inclusivity, representativeness and equitable benefit of their PR services.

METHODS

Semi-structured qualitative interviews were conducted in person or via videoconferencing with HCPs involved in PR from two healthcare providers. Interviews were analysed using reflexive thematic analysis.

RESULTS

12 interviews were conducted with physiotherapists ( = 6), occupational therapists ( = 2), nurses ( = 2) and exercise physiologists ( = 2). Participants had a median (IRQ) age of 43 (13) and 75% ( = 9) were female. Four themes were generated. 1: 'I don't really know as much as I should' [about protected characteristics]; 2: It's uncomfortable collecting protected characteristics…; 3: 'I don't think [service users] are as representative as they could be'; 4: A conventional rehabilitation programme does not meet the needs of all.

CONCLUSIONS

This study highlighted several challenges in HCPs understanding of protected characteristics and the representativeness of PR that must be addressed to ensure equity. Strategies, to understand barriers in accessing PR that limit representativeness should be explored.

摘要

背景

健康不平等可能会影响肺康复(PR)的获得和参与情况。个人的受保护特征(年龄、残疾、性别重新分配、婚姻和民事伴侣关系、怀孕和产假、种族、宗教或信仰、性别和性取向)可能导致健康不平等。然而,医疗保健专业人员(HCPs)对PR服务的包容性、代表性以及受保护特征的了解尚不清楚,而这对于识别和解决健康不平等至关重要。这项定性研究探讨了HCPs对受保护特征的理解以及他们对PR服务的包容性、代表性和公平受益的看法。

方法

与来自两家医疗保健机构参与PR的HCPs进行了面对面或通过视频会议的半结构化定性访谈。访谈采用反思性主题分析进行分析。

结果

对物理治疗师(n = 6)、职业治疗师(n = 2)、护士(n = 2)和运动生理学家(n = 2)进行了12次访谈。参与者的年龄中位数(四分位间距)为43岁(13岁),75%(n = 9)为女性。产生了四个主题。1:“我对[受保护特征]了解得不够多”;2:收集受保护特征让人不舒服……;3:“我认为[服务使用者]的代表性不够”;4:传统的康复计划不能满足所有人的需求。

结论

本研究强调了HCPs在理解受保护特征和PR的代表性方面存在的几个挑战,必须加以解决以确保公平。应该探索一些策略,以了解限制代表性的PR获取障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3f2/11733882/b53335d2da6e/10.1177_14799731241307253-fig1.jpg

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