Exploring Culturally Responsive Religious and Spirituality Health Care Communications among African Americans with Advanced Heart Failure, Their Family Caregivers, and Clinicians.
Exploring Culturally Responsive Religious and Spirituality Health Care Communications among African Americans with Advanced Heart Failure, Their Family Caregivers, and Clinicians.
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探索患有晚期心力衰竭的非裔美国人、他们的家庭护理人员和临床医生之间的文化响应式宗教和灵性医疗保健沟通。
DOI：
10.1089/jpm.2021.0044
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发表时间：
2021
影响因子：
2.8
通讯作者：
Bakitas,Marie
中科院分区：
文献类型：
--
作者：
Ejem,Deborah;Steinhauser,Karen;Dionne-Odom,JNicholas;Wells,Rachel;Durant,RaeganW;Clay,OlivioJ;Bakitas,Marie
背景：宗教和灵性（R/S）影响非裔美国人（AAs）应对严重疾病的方式，但在医患交流中很少被提及。目的：探讨晚期心力衰竭患者及其家庭照护者（FCGs）在医患沟通中对R/S的偏好。方法：在美国南部一个州的一项父母随机试验中，对R/S在疾病经历以及临床医生与患者和FCGs的互动中的作用进行了嵌入式定性访谈。使用持续的比较分析来分析记录的访谈，以确定紧急主题。结果：AA参与者（n= 15）平均年龄62岁，女性（40%），高中毕业文凭/GED（87%）。AA FCGs （n= 14）平均年龄58岁；女性（93%）；高中毕业文凭/普通教育发展文凭（93%）；并且失业（86%）。大多数（63%）是患者的配偶/伴侣。所有患者和FCGs均为新教徒。参与者报告了R/S在带病生活中的关键作用；然而，患者和FCGs对在卫生保健沟通中纳入R/S的观点不同。患者的观点如下：(1)在临床接触中不讨论R/S；(2)只有在患者主动提出的情况下才应该讨论R/S。FCGs关于理想R/S纳入的观点代表了三个主要的不同主题：(1)临床医生的R/S沟通不是优先事项，(2)临床医生应该公开承认患者的R/S信念，(3)临床医生应该与患者进行R/S对话。结论：关于R/S在疾病中的作用以及将R/S纳入医疗保健沟通的偏好的关键主题差异表明，需要对姑息治疗研究和实践的这方面进行评估和个性化。
Background:Religion and spirituality (R/S) impact how African Americans (AAs) cope with serious illness, yet are infrequently addressed in patient-clinician communication.Objectives:To explore AAs with advanced heart failure and their family caregivers' (FCGs) preferences about R/S in patient-clinician communication.Methods:An embedded qualitative interview within a parent randomized trial about the role of R/S in the illness experience and in clinician interactions with patients and FCGs in a Southern U.S. state. Transcribed interviews were analyzed using constant comparative analysis to identify emergent themes.Results:AA participants (n= 15) were a mean age of 62 years, were female (40%), and had >high school diploma/GED (87%). AA FCGs (n= 14) were a mean age of 58; were female (93%); had >high school diploma/General Education Development (GED) (93%); and were unemployed (86%). Most (63%) were patients' spouses/partners. All patients and FCGs were Protestant. Participants reported the critical role of R/S in living with illness; however, patients' and FCGs' perspectives related to inclusion of R/S in health care communications differed. Patients' perspectives were as follows: (1) R/S is not discussed in clinical encounters and (2) R/S should be discussed only if patient initiated. FCGs' perspectives about ideal inclusion of R/S represented three main diverging themes: (1) clinicians' R/S communication is not a priority, (2) clinicians should openly acknowledge patients' R/S beliefs, and (3) clinicians should engage in R/S conversations with patients.Conclusion:Key thematic differences about the role of R/S in illness and preferences for incorporating R/S in health care communications reveal important considerations about the need to assess and individualize this aspect of palliative care research and practice.