"Falling between the cracks": Experiences of Black dementia caregivers navigating U.S. health systems.
"Falling between the cracks": Experiences of Black dementia caregivers navigating U.S. health systems.
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DOI：
10.1111/jgs.17636
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发表时间：
2022-03
影响因子：
6.3
通讯作者：
Epps F
中科院分区：
文献类型：
--
作者：
Alexander K;Oliver S;Bennett SG;Henry J;Hepburn K;Clevenger C;Epps F
除了众多的护理责任外，家庭护理人员还应代表痴呆症患者（PLWD）浏览卫生系统并参与医疗保健管理任务。这些具有挑战性的任务给黑人痴呆症护理人员带来了额外的困难。由于黑人美国人有着悠久的弱势社会历史，出现了一些独特的压力源，脆弱性和资源，这些压力源，脆弱性和资源会影响黑人痴呆症护理人员的经历和福祉。焦点小组与来自美国的黑人护理人员（N = 19），以探讨这一人口的独特经验和观点导航美国卫生系统代表他们的PLWD。在专题分析过程中构建了五个首要主题：强制宣传，穷人提供者的互动，付款人来源支配护理，歧视和破碎的卫生系统。黑人痴呆症护理人员一致认为，他们在美国经历的卫生系统是“破碎的”。卫生系统的差距可能导致人们[正如一位护理人员热情地表示]在护理，服务和所需资源方面“陷入困境”。照顾者一致认为，阶级、性别、使用公共医疗保险以及作为一个“有色人种”导致了他们在医疗系统中的困难。照顾者认为被提供者解雇，迫使他们为自己和他们的PLWD辩护。医疗保健提供者和研究人员可以利用这些发现来改善患有痴呆症的黑人及其照顾者的经验和医疗保健结果。此外，这些发现可以导致文化定制的护理人员教育计划的发展。
In addition to numerous care responsibilities, family caregivers are expected to navigate health systems and engage in healthcare management tasks on behalf of their persons living with dementia (PLWD). These challenging tasks pose additional difficulties for Black dementia caregivers. Due to the centuries-old, disadvantaged social history of Black Americans, several unique stressors, vulnerabilities, and resources have emerged which inform and affect Black dementia caregivers’ experiences and well-being. Focus groups were held with Black caregivers (N = 19) from the United States to explore the unique experiences and perspectives of this population navigating the U.S. health system on behalf of their PLWD. Five overarching themes were constructed during thematic analysis: Forced Advocacy, Poor Provider Interaction, Payor Source Dictates Care, Discrimination, and Broken Health System. Black dementia caregivers unanimously concurred that the health system that they experience in America is “broken.” Gaps in the health system can lead to people [as one caregiver passionately expressed] “falling between the cracks,” in terms of care, services, and resources needed. Caregivers agreed that class, sex, utilizing public health insurance, and being a “person of color” contribute to their difficulties navigating the health system. Caregivers perceived being dismissed by providers, forcing them to advocate for both themselves and their PLWD. Healthcare providers and researchers can utilize these findings to improve the experiences and healthcare outcomes of Black persons living with dementia and their caregivers. Additionally, these findings can lead to the development of culturally tailored caregiver education programs.
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这是一个信任的问题：年长的非洲裔美国人谈论他们的医疗保健遭遇。
DOI：
10.1177/0733464815570662
发表时间：
2016-10
期刊：
Journal of applied gerontology : the official journal of the Southern Gerontological Society
影响因子：
--
作者：
Hansen BR;Hodgson NA;Gitlin LN
通讯作者：
Gitlin LN
影响因子：
5.9
作者：
Ali, Nida M.;Combs, Ryan M.;Ayangeakaa, Suur D.
通讯作者：
Ayangeakaa, Suur D.
DOI：
10.1097/njh.0b013e318243920c
发表时间：
2012-05-01
期刊：
Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association
影响因子：
--
作者：
Watkins YJ;Bonner GJ;Wang E;Wilkie DJ;Ferrans CE;Dancy B
通讯作者：
Dancy B
影响因子：
5.7
作者：
Fabius, Chanee D.;Wolff, Jennifer L.;Kasper, Judith D.
通讯作者：
Kasper, Judith D.
影响因子：
14
作者：
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