Black cancer patients navigating a health-care system of racial discrimination.
Black cancer patients navigating a health-care system of racial discrimination.
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黑人癌症患者在充满种族歧视的医疗保健系统中挣扎。
DOI：
10.1093/jnci/djad208
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Farias,AlbertJ
中科院分区：
文献类型：
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作者：
Garrett,Elleyse;Ma,Cindy;Ochoa-Dominguez,CarolY;Navarro,Stephanie;Yoon,Paul;HughesHalbert,Chanita;Farias,AlbertJ
暴露于种族歧视可能会加剧整个癌症治疗连续体的差异。因此，我们探讨了医疗保健环境中的种族歧视经历如何在黑人癌症患者中表现出来，以及它如何导致癌症护理中的种族差异。方法：本定性分析采用半结构化深度访谈，对2019年5月至2020年3月未接受积极治疗的黑人癌症幸存者进行访谈。所有访谈录音，专业转录，并上传到Dedoose软件进行分析。我们确定了主要主题和次要主题，强调种族歧视及其对黑人癌症患者在接受癌症治疗时的后果。结果研究对象包括18名黑人癌症幸存者，年龄29-88岁。大多数患者在寻求治疗时经历了种族歧视。参与者在与保健工作人员、医疗助理、前台工作人员和健康保险管理人员的互动中经历了种族歧视。在医疗保健环境中受到公然的种族歧视的根源是种族成见，并表现为口头侮辱，例如医生使用诸如“你们这些人”之类的短语。这些经历影响了卫生保健提供系统展示可信度的能力。患者表示，他们的健康问题没有得到解决，就“走了出去”。尽管有过种族歧视的经历，病人仍然出于必要而寻求治疗，认为这是黑人个人经历中不可避免的一部分。结论我们发现，在医疗保健环境中，种族歧视的暴露是普遍存在的，影响了求医行为，降低了医患关系，这可能是导致癌症护理中的种族差异的原因。
BackgroundExposure to racial discrimination may exacerbate disparities throughout the cancer care continuum. Therefore, we explored how experiences of racial discrimination in the health-care setting manifest for Black cancer patients and how it contributes to racial disparities in cancer care.MethodsThis qualitative analysis used semistructured in-depth interviews with Black cancer survivors not on active treatment from May 2019 to March 2020. All interviews were audio recorded, professionally transcribed, and uploaded into Dedoose software for analysis. We identified major themes and subthemes that highlight exposure to racial discrimination and its consequences for Black cancer patients when receiving cancer care.ResultsParticipants included 18 Black cancer survivors, aged 29-88 years. Most patients experienced racial discrimination when seeking care. Participants experienced racial discrimination from their interactions with health-care staff, medical assistants, front desk staff, and health insurance administrators. Exposure to overt racial discrimination in the health-care setting was rooted in racial stereotypes and manifested through verbal insults such as physicians using phrases such as “you people.” These experiences impacted the ability of the health-care delivery system to demonstrate trustworthiness. Patients noted “walking out” of their visit and not having their health issues addressed. Despite experiences with racial discrimination, patients still sought care out of necessity believing it was an inevitable part of the Black individual experience.ConclusionWe identified that exposure to racial discrimination in the health-care setting is pervasive, affects health-seeking behaviors, and degrades the patient–clinician relationship, which may likely contribute to racial disparities in cancer care.