A chasm between injury and care: experiences of black male victims of violence.
A chasm between injury and care: experiences of black male victims of violence.
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DOI：
10.1097/ta.0b013e3181e74fcf
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发表时间：
2010-12
期刊：
影响因子：
--
通讯作者：
James T
中科院分区：
文献类型：
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作者：
Liebschutz J;Schwartz S;Hoyte J;Conoscenti L;Christian AB Sr;Muhammad L;Harper D;James T
尽管黑人男性的刺杀和枪击暴力发生率较高，但医疗系统并未对这些患者做出有效的反应。这项研究描述了让暴力的黑人男性受害者接受医疗和精神保健的挑战和促进因素。刺杀和枪击事件的黑人男性受害者通过传单和口碑招募，并使用半结构化指南单独采访(n=12)或成对采访(n=4)。一个不同种族的多学科团队使用扎根理论的方法分析了数据。参与医疗保健的挑战包括：(1)事后断开联系；例如，参与者报告没有意识到他们受了重伤(“只是擦伤”“戳”)，迷失了方向(“不知道我在哪里”)，或者被愤怒吞噬。(2)制度上的不信任：医疗保健和警察之间的界限模糊，金钱驱动的护理。(3)缩短的未来：预期他们会英年早逝。(4)自力更生：自己解决精神和物质滥用问题。(5)后勤问题：伤后精神健康症状、残疾和安全问题对康复和参与医疗保健造成了结构性障碍。促进因素包括：(1)渴望职业精神、开放的个性和来自临床医生的分享经验；(2)转折点：孩子的受伤或出生是一个“警钟”；(3)积极的人、面向未来的朋友和家人。对于黑人男性暴力受害者，医疗没有处理伤害的情况和反应。界定医疗和执法之间的界限并解决受伤后心理健康症状、残疾和安全问题的政策可能会改善康复进程。
Despite higher rates of stabbing and shooting violence among black men, healthcare systems have not demonstrated an efficacious response to these patients. This study describes challenges and promotive factors for engaging black male violence victims of violence with medical and mental healthcare. Black male victims of stabbings and shootings were recruited through fliers and word of mouth, and were interviewed individually (n = 12) or in pairs (n = 4) using a semistructured guide. A racially diverse multidisciplinary team analyzed the data using Grounded Theory methods. Challenges to engagement with healthcare included the following: (1) Disconnect in the aftermath; e.g. participants reported not realizing they were seriously injured (“just a scratch” “poke”), were disoriented (“did not know where I was”), or were consumed with anger. (2) Institutional mistrust: blurred lines between healthcare and police, money-motivated care. (3) Foreshortened future: expectations they would die young. (4) Self-reliance: fix mental and substance abuse issues on their own. (5) Logistical issues: postinjury mental health symptoms, disability, and safety concerns created structural barriers to recovery and engagement with healthcare. Promotive factors included the following: (1) desire professionalism, open personality, and shared experience from clinicians; (2) turning points: injury or birth of a child serve as a “wake up call”; and (3) positive people, future-oriented friends and family. For black male violence victims, medical treatment did not address circumstances of and reactions to injury. Policies delineating boundaries between medical care and law enforcement and addressing postinjury mental health symptoms, disability, and safety concerns may improve the recovery process.