Understanding Differences in Medical Student Perceptions of Treatment Adherence Based on Weight Status in Pediatric Care.

IF 1.6 3区 心理学 Q3 PSYCHOLOGY, CLINICAL
Molly C Basch, Francesca Lupini, David M Janicke
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Abstract

Obesity biases in healthcare are detrimental. We explored medical student beliefs underlying perceptions that child-mother dyads with obesity are less likely to be treatment adherent. Participants viewed scenes of a 12-year-old, female virtual human presenting to a physician with back pain, accompanied by her mother. Patient and mother weight cues were manipulated across scenes. Out of 120, 35 participants perceived dyads with obesity as less adherent to hypothetical pain-related treatment recommendations relative to dyads with healthy weight. These participants were informed and asked why. Responses were analyzed for themes. Fifty-two responses revealed three codes relating to participants' explanation of why they perceived lower adherence for dyads with obesity-obesity is associated with: 1) non-compliance with general health recommendations, 2) internal traits/factors (i.e., mothers' less health consciousness, mental strength), 3) external factors (i.e., lower health literacy, socioeconomic status). The association of obesity with lower adherence is a bias that may exist among medical students and originate from assumptions about prior health adherence and maternal traits, some disparaging in nature. Such bias has potential to contribute to healthcare disparities. Findings highlight the utility of qualitative methods to understand beliefs driving perceptions and design bias-reducing interventions to trainee needs.

Abstract Image

了解医学生对儿科护理中基于体重状况的治疗依从性的看法差异。
医疗保健中的肥胖偏见是有害的。我们探讨了医科学生认为肥胖儿童和母亲不太可能坚持治疗的观点。参与者观看了一个 12 岁女性虚拟人在母亲陪同下因背部疼痛向医生求诊的场景。患者和母亲的体重线索在不同场景中进行了处理。在 120 位参与者中,有 35 位参与者认为肥胖的双人组与体重健康的双人组相比,对假设的疼痛相关治疗建议的依从性较低。我们告知了这些参与者并询问了原因。我们对这些回答进行了主题分析。52 份回复显示了三个代码,这些代码与参与者解释为何他们认为肥胖人群的依从性较低有关--肥胖与以下因素有关:1)不遵守一般健康建议;2)内部特征/因素(即母亲健康意识较差、精神力量);3)外部因素(即健康知识水平较低、社会经济地位)。将肥胖与较低的依从性联系起来是一种偏见,这种偏见可能存在于医科学生中,源于对先前的健康依从性和母亲特质的假设,其中有些是贬低性的。这种偏见有可能导致医疗保健差异。研究结果凸显了定性方法的实用性,可用于了解驱动认知的信念,并根据受训者的需求设计减少偏见的干预措施。
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来源期刊
CiteScore
4.00
自引率
4.50%
发文量
93
期刊介绍: Journal of Clinical Psychology in Medical Settings is an international forum for the publication of peer-reviewed original papers related to all areas of the science and practice of psychologists in medical settings. Manuscripts are chosen that have a broad appeal across psychology as well as other health care disciplines, reflecting varying backgrounds, interests, and specializations. The journal publishes original research, treatment outcome trials, meta-analyses, literature reviews, conceptual papers, brief scientific reports, and scholarly case studies. Papers accepted address clinical matters in medical settings; integrated care; health disparities; education and training of the future psychology workforce; interdisciplinary collaboration, training, and professionalism; licensing, credentialing, and privileging in hospital practice; research and practice ethics; professional development of psychologists in academic health centers; professional practice matters in medical settings; and cultural, economic, political, regulatory, and systems factors in health care. In summary, the journal provides a forum for papers predicted to have significant theoretical or practical importance for the application of psychology in medical settings.
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