When worlds intersect: practical and ethical challenges when caring for international patients in the NICU
When worlds intersect: practical and ethical challenges when caring for international patients in the NICU
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当世界相交时：在新生儿重症监护病房（NICU）照顾国际患者时面临的实际和道德挑战
DOI：
10.1038/jp.2015.106
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发表时间：
2015
影响因子：
2.9
通讯作者：
Cummings
中科院分区：
文献类型：
--
作者：
Langer;Cummings
儿科保健已变得日益全球化，甚至在新生儿重症监护病房(NICU)也是如此。1工业化国家的保健小组经常在资源较差的情况下提供儿科保健。相反，家庭有时会在全球各地旅行，为他们的婴儿或儿童寻求在其原籍国无法获得的专门医疗护理，包括新生儿重症监护。1-4在全球范围内，在过去的20年里，‘医疗旅游’或‘国际医疗旅行’(IMT)迅速增长。在线医疗信息获取的改善和运输成本的降低是IMT增加的原因之一。5卫生保健机构认识到创业机会，也开始在其国内市场以外积极招聘病人。6通过IMT获得高质量儿科护理的机会对一些患者和家属极为有益。他们可能会得到一种以前他们不知道的诊断，或者有一种治疗方法可以显著提高生活质量，甚至是治愈的。然而，对于其他患者和家属来说，这样的机会可能会导致不太理想的结果，带来独特的实践和伦理挑战。文化、语言和价值观的差异都可能导致潜在的沟通不畅和期望的错位，可能导致各方失望、沮丧甚至道德痛苦。这种跨文化挑战并不是国际患者独有的，但其他因素可能会加剧这种挑战，包括对美国医疗保健系统的不熟悉、不一致的期望以及离家很远而没有必要的支持系统。本文讨论了在美国NICU护理国际患者及其家人时可能出现的一些常见问题。在这一讨论中，国际患者可以被定义为带着获得国外医疗服务的明确目的旅行的人，7他要么自掏腰包支付所接受的服务，要么通过外国付款人/赞助商支付费用。2.
Pediatric health care has become increasingly globalized, even in the neonatal intensive care unit (NICU). 1 Health-care teams from industrialized countries frequently provide pediatric care in poorer resource settings. Conversely, families sometimes travel across the globe to pursue specialized medical care for their infant or child that is otherwise unavailable in their country of origin, including neonatal intensive care. 1–4 Worldwide, over the past 2 decades there has been a rapid increase in ‘medical tourism’or ‘international medical travel’(IMT). Improved access to healthcare information online and lowered transportation costs have contributed to an increase in IMT. 5 Recognizing entrepreneurial opportunity, health-care institutions have also started to actively recruit patients outside their domestic markets. 6 Opportunities for high quality pediatric care through IMT can be extremely beneficial for some patients and families. They may receive a diagnosis formerly not known to them or a treatment becomes available which substantially improves the quality of life or is even curative. For other patients and families, however, such opportunities may lead to sub-optimal outcomes, posing unique practical and ethical challenges. Differences in culture, language and values can all contribute to potential miscommunication and misalignment of expectations, possibly leading to disappointment, frustration or even moral distress for all parties involved. Such cross-cultural challenges are not unique to international patients, but can be compounded by additional factors, including unfamiliarity with the US health-care system, misaligned expectations and great distances away from home without necessary support systems.This article addresses some common issues that can arise when caring for international patients and their families in NICUs in the United States. For this discussion, an international patient can be defined as a person who travels with the ‘express purpose of obtaining health-care services abroad,’7 who either pays out-of-pocket for the services received or is covered through a foreign payer/sponsor. 2
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影响因子：
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作者：
D. Badulescu;A. Badulescu
通讯作者：
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DOI：
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发表时间：
2013
期刊：
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作者：
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影响因子：
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作者：
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通讯作者：
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“Wer bietet Übersetzung an, wenn man mich nicht verstehen kann?”
DOI：
--
发表时间：
2014
期刊：
影响因子：
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作者：
C. Engelbrecht;C. Schlösser;C. Schütt;G. Hebborn;und Iag Studierende Patienteninformation
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und Iag Studierende Patienteninformation
DOI：
10.2471/blt.10.076612
发表时间：
2011-01-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Helble, Matthias
通讯作者：
Helble, Matthias