Understanding negative feedback from South Asian patients: an experimental vignette study.
Understanding negative feedback from South Asian patients: an experimental vignette study.
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DOI：
10.1136/bmjopen-2016-011256
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发表时间：
2016-09-08
期刊：
影响因子：
2.9
通讯作者：
Roland M
中科院分区：
文献类型：
--
作者：
Burt J;Abel G;Elmore N;Lloyd C;Benson J;Sarson L;Carluccio A;Campbell J;Elliott MN;Roland M
在许多国家，少数民族在患者调查中报告的护理较差。这可能是因为他们得到的照顾更差，或者是因为他们对这类调查的反应不同。我们进行了一项实验，以确定英国的南亚人对模拟全科医生咨询的看法与英国白人相同还是不同。如果这些群体在观看相同的模拟咨询时对咨询的评价相似，则更有可能是少数民族在实际调查中报告的较低分数反映了护理质量的真正差异。实验小插图研究。训练有素的现场工作人员完成了计算机辅助的个人访谈，在此期间，参与者使用来自英国全科医生患者调查的5个沟通项目对模拟全科医生患者咨询的3个视频录音进行评分。咨询以随机顺序显示，从16个咨询中选择。英格兰约130户家庭（产出区）的地理限制区域，采用比例系统抽样选择。564名英国白人和564名巴基斯坦成年人通过在家面对面的方式被招募。根据线性回归估计，英国白人和巴基斯坦白人参与者之间交流得分（0-100分）的平均差异。在观看相同的咨询时，巴基斯坦参与者的平均得分比英国白人参与者高9.8分（95% CI 8.0至11.7,p<0.001）。当对年龄、性别、贫困、自评健康状况和视频进行调整后，差异增加到11.0点（95% CI 8.5至13.6,p<0.001）。当参与者年龄较大（55岁左右），且沟通被设定得很差时，差异最大。不同群体之间的评分存在显著差异，巴基斯坦受访者对同样关怀的视频的评分高于英国白人受访者。我们的研究结果表明，巴基斯坦患者在全国调查中报告的较低分数，与占多数的英国白人相比，确实代表了更糟糕的沟通经历。
In many countries, minority ethnic groups report poorer care in patient surveys. This could be because they get worse care or because they respond differently to such surveys. We conducted an experiment to determine whether South Asian people in England rate simulated GP consultations the same or differently from White British people. If these groups rate consultations similarly when viewing identical simulated consultations, it would be more likely that the lower scores reported by minority ethnic groups in real surveys reflect real differences in quality of care. Experimental vignette study. Trained fieldworkers completed computer-assisted personal interviews during which participants rated 3 video recordings of simulated GP–patient consultations, using 5 communication items from the English GP Patient Survey. Consultations were shown in a random order, selected from a pool of 16. Geographically confined areas of ∼130 households (output areas) in England, selected using proportional systematic sampling. 564 White British and 564 Pakistani adults recruited using an in-home face-to-face approach. Mean differences in communication score (on a scale of 0–100) between White British and Pakistani participants, estimated from linear regression. Pakistani participants, on average, scored consultations 9.8 points higher than White British participants (95% CI 8.0 to 11.7, p<0.001) when viewing the same consultations. When adjusted for age, gender, deprivation, self-rated health and video, the difference increased to 11.0 points (95% CI 8.5 to 13.6, p<0.001). The largest differences were seen when participants were older (>55) and where communication was scripted to be poor. Substantial differences in ratings were found between groups, with Pakistani respondents giving higher scores than White British respondents to videos showing the same care. Our findings suggest that the lower scores reported by Pakistani patients in national surveys represent genuinely worse experiences of communication compared to the White British majority.
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影响因子：
3
作者：
Setodji, Claude M.;Elliott, Marc N.;Campbell, John
通讯作者：
Campbell, John
影响因子：
6
作者：
Kurtz, SM;Silverman, JD
通讯作者：
Silverman, JD
影响因子：
4.8
作者：
Becares, Laia;Das-Munshi, Jayati
通讯作者：
Das-Munshi, Jayati
影响因子：
3.4
作者：
Weinick, Robin M.;Elliott, Marc N.;Schlesinger, Mark
通讯作者：
Schlesinger, Mark
DOI：
10.1136/bmj.b3450
发表时间：
2009-09-16
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Mead N;Roland M
通讯作者：
Roland M