Reducing health disparities in providing care services in the intensive care unit: a critical ethnographic study.

IF 3 1区 哲学 Q1 ETHICS BMC Medical Ethics Pub Date : 2024-10-23 DOI:10.1186/s12910-024-01118-9
Sajad Yarahmadi, Mohsen Soleimani, Mohammad Gholami, Ali Fakhr-Movahedi, Seyed Mohsen Saeidi Madani
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Abstract

Objective: The intensive care unit, with its structural complexity and the exposure of critically ill patients to various disparities, presents a significant setting for health disparities. This critical ethnographic study sought to uncover cultural knowledge and ethical practices for reducing health disparities in providing care services within the intensive care unit. The focus was on understanding how ethical considerations and cultural competence can address and mitigate these disparities effectively.

Methods: This critical ethnographic study was conducted in 2022-2023 at intensive care units in western Iran. Three interrelated phases were used to collect and analyze the data. More than 300 h of observation were done during the first phase. A horizon analysis was carried out in the next phase. To further enhance the dataset, 18 informants participated in semi-structured interviews and informal conversations. Following that, the analysis procedure was conducted to identify a culture of health disparities and factors that reduce it, as it had been in the prior stage. Trustworthiness data collection methods were implemented to ensure the validity and reliability of the study.

Findings: Two key themes emerged from the study: (A) Improved cultural competence, which encompassed empathy towards patients and their families, effective communication, prioritization of continuous learning, appropriate knowledge and awareness, sensitivity to cultural and religious beliefs, staff attitude and personality, and the delivery of customized care tailored to each patient's needs. (B) Supporting role and compensating for disparities involved recommendations for upholding ethical standards, compensatory actions, maintaining professional behavior despite external factors, addressing gaps and deficiencies, and actively defending and supporting patients.

Conclusion: The findings indicate that staff with high cultural competence can ethically mitigate health disparities through their supportive roles. Managers and health policymakers should create barriers to health disparity by improving staff cultural competence and knowledge about health disparities.

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在重症监护室提供护理服务时减少健康差异:一项重要的人种学研究。
目的:重症监护室结构复杂,重症患者面临各种差异,是造成健康差异的重要场所。这项重要的人种学研究旨在揭示在重症监护病房提供护理服务时,如何通过文化知识和伦理实践来减少健康差异。重点是了解伦理考虑因素和文化能力如何有效地解决和减少这些差异:这项重要的人种学研究于 2022-2023 年在伊朗西部的重症监护病房进行。收集和分析数据分为三个相互关联的阶段。第一阶段进行了 300 多小时的观察。下一阶段进行了视野分析。为了进一步完善数据集,18 名信息提供者参加了半结构化访谈和非正式谈话。随后,与前一阶段一样,进行了分析程序,以确定健康差异文化和减少差异的因素。为确保研究的有效性和可靠性,采用了可信数据收集方法:研究提出了两个关键主题:(A)提高文化能力,包括对病人及其家属的同理心、有效沟通、优先考虑持续学习、适当的知识和意识、对文化和宗教信仰的敏感性、员工的态度和个性,以及根据每个病人的需求提供定制护理。(B) 支持角色和补偿差异涉及以下方面的建议:坚持道德标准、补偿行动、在外部因素影响下保持专业行为、解决差距和不足、积极维护和支持患者:研究结果表明,具有较高文化素养的医务人员可以通过其支持性角色在道德上减少健康差异。管理者和卫生政策制定者应通过提高员工的文化素养和对健康差异的了解,为消除健康差异设置障碍。
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来源期刊
BMC Medical Ethics
BMC Medical Ethics MEDICAL ETHICS-
CiteScore
5.20
自引率
7.40%
发文量
108
审稿时长
>12 weeks
期刊介绍: BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.
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