"This happens all the time": a Qualitative Study of General Internists' Experiences with Discriminatory Patients.
"This happens all the time": a Qualitative Study of General Internists' Experiences with Discriminatory Patients.
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“这种情况一直在发生”：一项关于普通内科医生对待歧视性患者的经验的定性研究。
DOI：
10.1007/s11606-021-06696-7
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发表时间：
2021-06
影响因子：
5.7
通讯作者：
Carnes M
中科院分区：
文献类型：
--
作者：
Filut A;Alexander L;Ray A;Pecanac K;Carnes M
职场歧视对有色人种医生的个人和职业都有负面影响。尽管在社交媒体、大众媒体和个人文章中都可以看到患者歧视的发生，但很少有研究将患者作为针对有色人种医生的歧视的来源。探索普通内科医生观察或与有色人种医生表现出歧视行为的患者互动的经验。一项定性研究，在2019年5月至9月期间进行并记录了深入、半结构化、一对一的电话访谈。在美国12个学术健康中心执业的24名普通内科医生的目的样本：14名自认为是白人，10名自认为是有色人种的医生，其中包括亚洲人、黑人、美洲原住民和自认为是其他种族的医生。四名编码员对转录和验证的采访文本进行分析；主位分析用于归纳识别衔接主位和次主位。分析揭示了四个主要主题：(1)假设一个合法的医生是白人、男性、健全的；(2)黑人经历的遗产；(3)与歧视作斗争；(4)为歧视患者提供护理的伦理困境。除了患者因医生的种族或民族而受到歧视外，参与者还描述了因医生的性别和残疾状况而遭受或观察到的歧视。与会者普遍表示需要更多同事的支持和更多体制政策的指导。在学术环境中执业的全科内科医生报告说，他们观察到或经历过患者基于他们的种族、民族、性别（或他们的交集）、残疾状况和为这些患者提供护理的道德困境的歧视。这些结果提供了越来越多的证据，表明机构需要通过政策和具体指导来更好地支持日益多样化的医生队伍，以帮助医生在提供高质量护理的同时应对患者的歧视。在线版本包含补充材料，可在10.1007/s11606-021-06696-7获得。
Workplace discrimination negatively affects physicians of color personally and professionally. Although the occurrence of discrimination from patients has been visible in social media, popular press, and personal essays, scant research exists on patients as a source of discrimination directed at physicians of color. To explore practicing general internists’ experiences observing or interacting with patients exhibiting discriminatory behavior directed at physicians of color. A qualitative study with in-depth, semi-structured, one-on-one telephone interviews conducted and recorded between May and September 2019. A purposive sample of 24 general internists practicing at 12 academic health centers in the USA: 14 self-identified as White and 10 as a physician of color, which included Asian, Black, Native American, and self-identified other race. Four coders analyzed the transcribed and verified interview text; thematic analysis was used to inductively identify cohesive themes and subthemes. Analyses revealed four major themes: (1) assumption that a legitimate doctor is White, male, and able-bodied; (2) legacy of the Black experience; (3) working through the struggle of discrimination; and (4) ethical dilemma of providing care to discriminatory patients. In addition to discrimination from patients based on a physician’s race or ethnicity, participants described experiencing or observing discrimination based on a physician’s gender and disability status. Participants generally expressed a need for greater support from colleagues and more guidance from institutional policies. General internists practicing in academic settings reported observing or experiencing discrimination from patients based on the physician’s race, ethnicity, gender (or their intersection), and disability status and the ethical dilemma of providing care to such patients. These results contribute to growing evidence of the need for institutions to better support an increasingly diverse physician workforce with policies and specific guidance to help physicians respond to discrimination from patients while still providing quality care. The online version contains supplementary material available at 10.1007/s11606-021-06696-7.
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影响因子：
2.4
作者：
Carnes, Molly;Devine, Patricia G.;Sheridan, Jennifer
通讯作者：
Sheridan, Jennifer
影响因子：
1.7
作者：
Guest, Greg;Bunce, Arwen;Johnson, Laura
通讯作者：
Johnson, Laura
影响因子：
7.4
作者：
Carnes, Molly;Devine, Patricia G.;Sheridan, Jennifer
通讯作者：
Sheridan, Jennifer
影响因子：
3.8
作者：
Cheryan, Sapna
通讯作者：
Cheryan, Sapna
DOI：
10.1097/acm.0b013e31823035e1
发表时间：
2011-11
期刊：
Academic medicine : journal of the Association of American Medical Colleges
影响因子：
--
作者：
Chen PG;Curry LA;Bernheim SM;Berg D;Gozu A;Nunez-Smith M
通讯作者：
Nunez-Smith M