Reflections of Healthcare Experiences of African Americans With Sickle Cell Disease or Cancer: A Qualitative Study
Reflections of Healthcare Experiences of African Americans With Sickle Cell Disease or Cancer: A Qualitative Study
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DOI：
10.1097/ncc.0000000000000750
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发表时间：
2021-01-01
期刊：
影响因子：
2.6
通讯作者：
Ezenwa, Miriam O.
中科院分区：
文献类型：
--
作者：
Dyal, Brenda W.;Abudawood, Khulud;Ezenwa, Miriam O.
背景非裔美国成年患者在急性护理利用之前、期间和之后的经历对于患有镰状细胞病（SCD）或癌症的个体来说并没有很好的特征。目的描述非裔美国人SCD或癌症患者在住院治疗疼痛控制之前、期间和之后的经历。我们对患有SCD（n = 15; 11名男性;平均年龄，32.7 ± 10.9岁;平均疼痛强度，7.8 ± 2.6）或癌症（n = 15; 7名男性;平均年龄，53.7 ± 15.2岁;平均疼痛强度，4.9 ± 3.7）的非裔美国人参与者进行了定性研究。参与者使用PAINReportIt完成人口统计学问题和疼痛强度，并回答了7项开放式访谈，该访谈被逐字记录和转录。我们使用内容分析来确定参与者回答中的主题。结果主题包括入院原因、住院经历和出院期望。疼痛是SCD受试者（n = 15）和大多数癌症受试者（n = 10）入院的主要原因。两组参与者都表示，他们经历了延迟治疗和缺乏沟通。患有SCD的参与者还报告了对寻求药物行为的指控，感知到的虐待，以及没有被倾听或相信的感觉。两组的参与者都表达了对出院后幸福感的担忧和充满希望的期望。结论种族一致的参与者与SCD，但不与癌症沟通感知的偏见，从医疗服务提供者。实践的影响需要实践改变干预措施，以改善患者与提供者的互动，减少隐性偏见，增加相互信任，以及促进更有效的疼痛控制，特别是对于那些患有SCD的患者。
BackgroundThe experiences of African American adult patients before, during, and after acute care utilization are not well characterized for individuals with sickle cell disease (SCD) or cancer. ObjectiveTo describe the experiences of African Americans with SCD or cancer before, during, and after hospitalization for pain control. MethodsWe conducted a qualitative study among African American participants with SCD (n = 15; 11 male; mean age, 32.7 +/- 10.9 years; mean pain intensity, 7.8 +/- 2.6) or cancer (n = 15; 7 male; mean age, 53.7 +/- 15.2 years; mean pain intensity, 4.9 +/- 3.7). Participants completed demographic questions and pain intensity using PAINReportIt and responded to a 7-item open-ended interview, which was recorded and transcribed verbatim. We used content analysis to identify themes in the participants' responses. ResultsThemes identified included reason for admission, hospital experiences, and discharge expectations. Pain was the primary reason for admission for participants with SCD (n = 15) and for most participants with cancer (n = 10). Participants of both groups indicated that they experienced delayed treatment and a lack of communication. Participants with SCD also reported accusations of drug-seeking behavior, perceived mistreatment, and feeling of not being heard or believed. Participants from both groups verbalized concerns about well-being after discharge and hopeful expectations. ConclusionsRace-concordant participants with SCD but not with cancer communicated perceived bias from healthcare providers. Implications for PracticePractice change interventions are needed to improve patient-provider interactions, reduce implicit bias, and increase mutual trust, as well as facilitate more effective pain control, especially for those who with SCD.