Diverse patient perspectives on respect in healthcare: A qualitative study

Mary Catherine Beach; Emily Branyon; Somnath Saha

摘要

? 2017 ? 2017 Background The dominant view of respect in western bioethics focuses almost exclusively on respect for autonomy (or ‘self-rule’) as conceptualized primarily from the perspective of philosophers. We designed this study to understand, from the perspective of patients from different racial/ethnic groups, what it means for patients to be treated with respect in healthcare settings. Methods We conducted focus groups with African American, Latino, and white patients in the Northwestern U.S. Focus groups were community-based and stratified by race and gender. We asked participants to describe respectful and disrespectful physician behaviors. We reviewed transcripts and coded for: 1) definitions of respect and 2) specific behaviors that convey respect or disrespect. Results We conducted 26 focus groups, 5 each with African American men and women, 4 each with Latino men and women, and 4 each with white men and women. We identified two primary definitions of respect described by all three racial/ethnic groups. These were: 1) being treated like a person (“like you're a person not just a statistic, or another patient”), and 2) being treated as an equal (“treat me as an equal, like I matter”). When exploring specific behaviors that convey respect or disrespect, there were largely similar themes identified by all or most racial/ethnic groups. These were being known as a particular individual, avoidance of stereotyping, being treated politely, honest explanations of medical issues, and how lateness is handled. There were also some differences across racial/ethnic groups. The most prominent demonstration of respect mentioned among African American participants were for physicians to hear vs. dismiss what patients say and trusting the patient's knowledge of him/herself. The most prominent demonstration of respect discussed in the Latino focus groups was having the provider show concern by asking the questions about the patient's clinical condition. Conclusions Our study found that patients have insights not included in common definitions of respect, and that deliberate inclusion of diverse participants increased the number of themes that emerged. Understanding what makes patients from different backgrounds feel respected and disrespected, from the perspectives of patients themselves, is vital to delivering care that is truly patient-centered. Background The dominant view of respect in western bioethics focuses almost exclusively on respect for autonomy (or ‘self-rule’) as conceptualized primarily from the perspective of philosophers. We designed this study to understand, from the perspective of patients from different racial/ethnic groups, what it means for patients to be treated with respect in healthcare settings. Methods We conducted focus groups with African American, Latino, and white patients in the Northwestern U.S. Focus groups were community-based and stratified by race and gender. We asked participants to describe respectful and disrespectful physician behaviors. We reviewed transcripts and coded for: 1) definitions of respect and 2) specific behaviors that convey respect or disrespect. Results We conducted 26 focus groups, 5 each with African American men and women, 4 each with Latino men and women, and 4 each with white men and women. We identified two primary definitions of respect described by all three racial/ethnic groups. These were: 1) being treated like a person (“like you're a person not just a statistic, or another patient”), and 2) being treated as an equal (“treat me as an equal, like I matter”). When exploring specific behaviors that convey respect or disrespect, there were largely similar themes identified by all or most racial/ethnic groups. These were being known as a particular individual, avoidance of stereotyping, being treated politely, honest explanations of medical issues, and how lateness is handled. There were also some differences across racial/ethnic groups. The most prominent demonstration

机译：还2017年？ 2017年背景，西方生物伦理的主导视图几乎专注于尊重自治（或“自我规则”），主要是从哲学家的角度概念化。从不同种族/族群的患者的角度来看，我们设计了这项研究，从不同的种族/族裔群体的角度来看，患者在医疗保健环境中待治疗的意味着什么。方法采用非洲裔美国人，拉丁裔和白色患者在西北美国焦点小组中进行了焦点小组，以社区为基础，由种族和性别分类。我们要求参与者描述尊重和不尊重的医生行为。我们审查了成绩单并编码：1）尊重的定义和2）传达尊重或不尊重的具体行为。结果我们开展了26个焦点小组，每组5个焦点小组，其中4名非洲裔美国人和女性，每个人都有拉丁裔男女，4人，每个男性和女性都有4名。我们确定了所有三个种族/族裔群体描述的尊重的两个主要定义。这些是：1）像一个人一样对待（就像你不仅仅是一个人不仅仅是一个统计数据，或另一个患者“）和2）被视为平等的（”把我视为一个平等的，就像我很重要“）。探索传达尊重或不尊重的具体行为时，所有或大多数种族/民族都确定了很多类似的主题。这些被称为特定的个体，避免陈特记，受到礼貌，对医学问题的诚实解释以及如何处理迟到。种族/民族群体也有一些差异。在非洲裔美国人参与者中提到的尊重最突出的示范是医生听取与驳回患者所说和信任患者对他/自己的知识的影响。拉丁美洲焦点小组中讨论的最突出的展示是通过询问有关患者的临床状况的问题来表现出关注的问题。结论我们的研究发现，患者有洞察力不包括在尊重的共同定义中，并且故意包含各种参与者的含量增加了出现的主题的数量。了解从不同背景的患者感到尊重和不尊重的是，从患者自己的角度来看，对于确实患者为中心的护理至关重要。背景技术西方生物伦理的主导观点几乎专注于尊重自治权（或“自我规则”），主要从哲学家的角度概念化。从不同种族/族群的患者的角度来看，我们设计了这项研究，从不同的种族/族裔群体的角度来看，患者在医疗保健环境中待治疗的意味着什么。方法采用非洲裔美国人，拉丁裔和白色患者在西北美国焦点小组中进行了焦点小组，以社区为基础，由种族和性别分类。我们要求参与者描述尊重和不尊重的医生行为。我们审查了成绩单并编码：1）尊重的定义和2）传达尊重或不尊重的具体行为。结果我们开展了26个焦点小组，每组5个焦点小组，其中4名非洲裔美国人和女性，每个人都有拉丁裔男女，4人，每个男性和女性都有4名。我们确定了所有三个种族/族裔群体描述的尊重的两个主要定义。这些是：1）像一个人一样对待（就像你不仅仅是一个人不仅仅是一个统计数据，或另一个患者“）和2）被视为平等的（”把我视为一个平等的，就像我很重要“）。探索传达尊重或不尊重的具体行为时，所有或大多数种族/民族都确定了很多类似的主题。这些被称为特定的个体，避免陈特记，受到礼貌，对医学问题的诚实解释以及如何处理迟到。种族/民族群体也有一些差异。最突出的演示

Diverse patient perspectives on respect in healthcare: A qualitative study

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