在支持护士执业的初级保健机构中,冠状动脉疾病患者脂质筛查的种族差异缩小

IF 4.2 4区 医学 Q1 NURSING
Heather Brom PhD, RN, Lusine Poghosyan PhD, MPH, RN, FAAN, Jacqueline Nikpour PhD, RN, Barbara Todd DNP, CRNP, FAANP, Kathy Sliwinski BSN, Tresa Franz BS, MS, Jesse Chitta MS, Linda Aiken PhD, RN, FAAN, Margo Brooks Carthon PhD, APRN, FAAN
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引用次数: 0

摘要

背景冠状动脉疾病(CAD)是美国最常见的心脏病,与白人患者相比,它对黑人患者的影响尤为严重。定期的初级保健和血脂异常筛查和管理对于最佳CAD护理至关重要。执业护士(NP)越来越多地提供初级保健服务,尽管不支持的执业环境可能会限制他们这样做的能力。目的研究黑人和白人CAD患者在脂质筛查方面的差异是否与NP执业环境评分有关。方法将来自初级保健实践和医疗保险索赔的NPs的横断面调查数据联系起来,以评估2016年四个州(加利福尼亚州、佛罗里达州、新泽西州和宾夕法尼亚州)456个初级保健实践中111911名CAD患者(94%为白人,6%为黑人)的结果。NP初级保健组织氛围问卷用于评估NP实践环境,该问卷提供了受访者实践的支持性得分。考虑患者和实践特点的多水平回归模型用于评估研究目的。结果与白人CAD患者相比,黑人CAD患者接受年度脂质筛查的频率较低(77.0%vs.70.6%;p<;.001)。在考虑患者和实践特征的逻辑回归模型中,实践环境评分每增加一个标准差,黑人患者接受脂质筛查的几率就会增加5%。结论投资于NP实践环境,包括提高NP角色的知名度和加强与医生和管理人员的关系,可以缩小CAD管理中的种族差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Racial Disparities in Lipid Screening Among Patients With Coronary Artery Disease Narrowed in Primary Care Settings Supportive of Nurse Practitioners

Background

Coronary artery disease (CAD) is the most prevalent heart disease in the United States, and it disproportionately affects Black compared to White patients. Regular primary care and dyslipidemia screening and management are essential for optimal CAD care. Nurse practitioners (NPs) increasingly provide primary care services, though unsupportive practice environments may constrain their ability to do so.

Purpose

To examine whether disparities in lipid screening between Black and White patients with CAD were associated with the NP practice environment scores.

Methods

Cross-sectional survey data from NPs in primary care practices and Medicare claims were linked to evaluate outcomes among 111,911 CAD patients (94% White, 6% Black) across 456 primary care practices in four states (California, Florida, New Jersey, and Pennsylvania) in 2016. The NP-Primary Care Organizational Climate Questionnaire, which provides a score on the supportiveness of a respondent’s practice, was used to evaluate the NP practice environment. Multilevel regression models that accounted for patient and practice characteristics were used to evaluate the study aim.

Results

Compared to White patients with CAD, Black patients with CAD less frequently received annual lipid screening (77.0% vs. 70.6%; p < .001). In logistic regression models accounting for patient and practice characteristics, for every standard deviation increase in the practice environment score, Black patients experienced a 5% increase in odds of receiving lipid screening.

Conclusion

Investing in the NP practice environment, including increasing NP role visibility and strengthening relationships with physicians and administrators, may narrow racial disparities in CAD management.

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来源期刊
CiteScore
4.60
自引率
12.50%
发文量
50
审稿时长
54 days
期刊介绍: Journal of Nursing Regulation (JNR), the official journal of the National Council of State Boards of Nursing (NCSBN®), is a quarterly, peer-reviewed, academic and professional journal. It publishes scholarly articles that advance the science of nursing regulation, promote the mission and vision of NCSBN, and enhance communication and collaboration among nurse regulators, educators, practitioners, and the scientific community. The journal supports evidence-based regulation, addresses issues related to patient safety, and highlights current nursing regulatory issues, programs, and projects in both the United States and the international community. In publishing JNR, NCSBN''s goal is to develop and share knowledge related to nursing and other healthcare regulation across continents and to promote a greater awareness of regulatory issues among all nurses.
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