纳米比亚农村社区的医疗不信任、歧视和医疗保健经验。

IF 2.3 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Global Public Health Pub Date : 2024-01-01 Epub Date: 2024-05-08 DOI:10.1080/17441692.2024.2346207
Sean Prall, Brooke Scelza, Helen Elizabeth Davis
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引用次数: 0

摘要

大量证据表明,因遭受歧视和边缘化而产生的对医疗的不信任是少数群体健康差异的一个决定因素。然而,这些研究主要局限于美国和其他工业化国家。为了拓宽我们对医疗不信任在医疗决策中的作用的理解,我们在纳米比亚西北部一个医疗服务不足的农村原住民社区(n = 86)开展了一项关于医疗经验和看法的研究。我们将半结构化访谈问题与医疗不信任指数(MMI)相结合,旨在确定医疗不信任指数在非工业化人口中的相关性,并将指数得分与医疗经验报告进行比较。我们发现,医疗不信任是该社区的一个突出概念,与负面的医疗经历和歧视感密切相关。所报告的医疗保健经历表明,所感知到的无能、虐待和歧视导致了对医务人员的不信任。然而,对近期医疗经历的报告一般都是正面的。我们的研究结果表明,医疗不信任的概念可以有效地应用于全球南部的社区。这些人群与美国的少数民族社区一样,将歧视和边缘化的经历转化为对医疗的不信任。了解这些过程有助于解决健康差异问题,并帮助在服务不足的人群中开展有效的公共卫生推广活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medical mistrust, discrimination and healthcare experiences in a rural Namibian community.

Substantial evidence indicates that medical mistrust, resulting from experiences with discrimination and marginalisation, is a determinant of health disparities in minority populations. However, this research is largely limited to the US and other industrialised countries. To broaden our understanding of the role of medical mistrust on health-care decision making, we conducted a study on healthcare experiences and perceptions in a rural, underserved indigenous community in northwest Namibia (n = 86). Mixing semi-structured interview questions with the medical mistrust index (MMI), we aim to determine the relevance of the MMI in a non-industrialised population and compare index scores with reports of healthcare experiences. We find that medical mistrust is a salient concept in this community, mapping onto negative healthcare experiences and perceptions of discrimination. Reported healthcare experiences indicate that perceived incompetence, maltreatment and discrimination drive mistrust of medical personnel. However, reporting of recent healthcare experiences are generally positive. Our results indicate that the concept of medical mistrust can be usefully applied to communities in the Global South. These populations, like minority communities in the US, translate experiences of discrimination and marginalisation into medical mistrust. Understanding these processes can help address health disparities and aid in effective public health outreach in underserved populations.

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来源期刊
Global Public Health
Global Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
3.00%
发文量
120
期刊介绍: Global Public Health is an essential peer-reviewed journal that energetically engages with key public health issues that have come to the fore in the global environment — mounting inequalities between rich and poor; the globalization of trade; new patterns of travel and migration; epidemics of newly-emerging and re-emerging infectious diseases; the HIV/AIDS pandemic; the increase in chronic illnesses; escalating pressure on public health infrastructures around the world; and the growing range and scale of conflict situations, terrorist threats, environmental pressures, natural and human-made disasters.
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