Cultural health literacy: the experiences of Maori in palliative care
Cultural health literacy: the experiences of Maori in palliative care
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DOI：
10.1177/1757975918764111
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发表时间：
2018-12-01
影响因子：
2
通讯作者：
Peni, Tamati
中科院分区：
文献类型：
--
作者：
Kidd, Jacquie;Black, Stella;Peni, Tamati
健康素养是一个经常应用于患者发现和理解健康信息的能力的概念。然而，最近的文献将卫生专业人员的技能和卫生资源的可获得性作为个人和人口实现的卫生知识水平的重要因素。2014年，在新西兰奥蒂亚罗亚进行了一项定性研究，调查了在姑息治疗环境中毛利人(毛利人是新西兰奥蒂亚罗亚的土著人民)的健康知识普及情况。这项研究包括患者、家庭和卫生专业人员的经历。方法：对21名患者和6名关键信息者进行了个人半结构化访谈：一名医学专家、一名参与制定针对患者的特定文化反应的服务负责人、两名毛利人服务经理和两名毛利人健康团队负责人。共有54名提供姑息治疗服务的卫生专业人员参加了焦点小组会议。数据分析：采用一般归纳法进行专题分析。通过在研究小组之间共享对成绩单的分析，支持了分析的可信性和可靠性。在与相关研究团体的五次会议上，成员检查或受访者确认被用来寻求对中期结果的确认。发现：这项研究发现，伴随着一种限制生命的疾病而产生的震惊和悲伤，使患者和华纳的听力和处理健康信息变得非常困难。此外，卫生专业人员经常避免关于从积极治疗转向姑息治疗的“艰难对话”，这让患者和华诺对自己的选择和预后感到苦恼和困惑。最后，组织糟糕的文化健康素养可能影响了毛利人迟迟获得或避免姑息治疗的机会。
Health literacy is a concept that is frequently applied to the patient's ability to find and comprehend health information. However, recent literature has included the skill of the health professional and the accessibility of health resources as important factors in the level of health literacy achieved by individuals and populations. In 2014 a qualitative study undertaken in Aotearoa New Zealand, investigated the context of health literacy for Maori in a palliative care setting (Maori are the indigenous people of Aotearoa New Zealand). The study included the experiences of patients, whanau (families), and health professionals. Method: Individual semi-structured interviews were held with 21 patients, whanau and six key informants: a medical specialist, a service leader involved in developing culturally specific responses to patients, two Maori service managers, and two Maori health team leaders. Focus groups were held with a total of 54 health professionals providing palliative care services. Data analysis: A thematic analysis was undertaken using a general inductive approach. The trustworthiness and reliability of the analysis was supported by sharing analysis of the transcripts among the research team. Member checking or respondent validation was used in seeking confirmation of the interim findings at five hui (meetings) with the research communities involved. Findings: This study found that the shock and grief that attends a life-limiting illness made hearing and processing health information very difficult for patients and whanau. Further, 'hard conversations' about moving from active treatment to palliative care were often avoided by health professionals, leaving patients and whanau distressed and confused about their choices and prognosis. Finally, poor cultural health literacy on the part of organisations has likely impacted on late access to or avoidance of palliative care for Maori.