scholarly journals RACIAL-ETHNIC DISPARITIES IN ATTITUDES TOWARD PASSIVE AND ACTIVE EUTHANASIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S426-S426
Author(s):  
Sara M Moorman
Keyword(s):  
Health Care Providers ◽  
Assisted Suicide ◽  
Ethnic Disparities ◽  
Recent Experience ◽  
Care Providers ◽  
Physician Assisted Suicide ◽  
Policy And Practice ◽  
Loved One ◽  
Life Project ◽  
Racial Ethnic

Abstract This paper examined racial/ethnic differences in opinions about passive euthanasia (withdrawing or withholding treatment), suicide, and physician-assisted suicide. Data came from 1,832 participants in the 2013 Pew Religion and Public Life Project. Respondents from all racial/ethnic backgrounds were most likely to favor multiple forms of euthanasia. However, persons of color had a wider variety of opinions about euthanasia than did non-Hispanic whites. In multivariate multinomial logistic regressions, non-Hispanic whites had a 63% chance of approving broadly of euthanasia, while non-Hispanic blacks had a 40% chance, and Hispanics, a 49% chance. Opposition to euthanasia was most common among people with multiple disadvantages (e.g., educational attainment, immigrant status). Neither trust in health care providers nor recent experience with the death of a loved one explained these group differences. Results highlight large differences of opinion between the people who set policy and practice guidelines and those who lack this power and access.

Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions

2021 ◽  
pp. 003335492097466
Author(s):  
Matthew Z. Dudley ◽  
Rupali J. Limaye ◽  
Daniel A. Salmon ◽  
Saad B. Omer ◽  
Sean T. O’Leary ◽  
...  
Keyword(s):  
Black Women ◽  
Health Care Providers ◽  
White Women ◽  
Ethnic Disparities ◽  
Vaccine Safety ◽  
Care Providers ◽  
Vaccine Acceptance ◽  
Race Ethnicity ◽  
Perceive Risk ◽  
Racial Ethnic

Objectives Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women’s knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity. Methods We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs. Results Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women. Conclusions Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

Verlieservaringen bij kinderen: een leidraad voor hulpverleners

2021 ◽  
Author(s):  
L. KEIRSE ◽  
S. WILLEMS ◽  
E. NELIS ◽  
H. GEERTS ◽  
E. HOLVOET ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Stressful Life Events ◽  
Professional Support ◽  
Significant Other ◽  
Care Providers ◽  
Loved One ◽  
Loss Experience ◽  
Current Article ◽  
Developmental Phases ◽  
Support Family

Loss experience in children: a guideline for primary care Everyone gets confronted with severe loss experiences during life, such as bereavement of a significant other, loss of a loved one after a divorce or loss of one’s own capabilities due to illness. Health care providers need to be equipped with substantial knowledge about children’s experiences of grief and distress in order to support family members properly. Moreover, this can influence the next generation’s capabilities to cope with stressful life events. The current article describes the characteristics of loss experiences in children up to 11 years. Developmental phases, as well as the need to explain to children the 4 fundamental characteristics of death will be discussed (i.e. finality, irreversibility, universality and causality). While grief and distress in children can generally be managed by the immediate surrounding of the child, sometimes professional support is necessary, which is also discussed in this article. Finally, the authors present 4 key principles and concrete recommendations on how adults can respond to children who lost someone so that they can regain pleasure in life.

Examining measurement properties of the consumer-based cancer care value index (CCCVI) survey: A measure to identify quality improvement priorities in cancer care.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 222-222 ◽  
Author(s):  
San Keller ◽  
Manshu Yang ◽  
Kathleen J. Yost
Keyword(s):  
Quality Improvement ◽  
Subgroup Analysis ◽  
Cancer Care ◽  
Ethnic Disparities ◽  
Reliability And Validity ◽  
Measurement Properties ◽  
Sufficient Information ◽  
Care Providers ◽  
Cancer Types ◽  
Racial Ethnic

222 Background: Current approaches to measuring the quality of cancer care may not produce sufficient information to enable providers to structure care that aligns closely with their patients’ preferences. To close this gap, we developed the Consumer-based Cancer Care Value Index (CCCVI) survey, which assesses the aspects of cancer care that patients value the most and how their values align with their experience in receiving cancer care. Methods: The CCCVI field test included 721 adults who received cancer care in the last 12 months from 4 geographically diverse cancer care centers, including patients with varying stages of cancer, types of cancer, types of treatment (e.g., surgery, radiation, medical oncology), and demographic characteristics. The survey included items that asked patients to directly rate the “importance” of 24 aspects of cancer care, along with 24 corresponding items that measured the “frequency” with which they received each aspect of care. We evaluated the reliability and validity of the survey items, and developed “value grids” plots which visually depicted the “importance” scores against the “frequency” scores. We conducted subgroup analysis to examine income and racial/ethnic disparities in the extent of misalignment between patients’ values and experiences. Results: The survey demonstrated good internal consistency reliability (Cronbach’s alpha = 0.91) and acceptable-to-good construct and criterion validity. Value grids identified potential areas of improvement in the areas of how doctors communicate and how quickly patients get care. The subgroup analysis showed the most misalignments between patients’ values and experiences in the aspects of doctor communication for lower-income patients and in the aspects of getting care quickly for patients from racial/ethnic minority groups. Conclusions: The CCCVI survey is a reliable and valid tool for cancer care providers to identify top priority areas (i.e., high-importance but low-frequency areas) to facilitate their quality improvement efforts. It also recognizes subgroup variations in the misalignment between patients’ values and care experiences.

scholarly journals Experiences of everyday racism in Toronto’s health care system: a concept mapping study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Deb Finn Mahabir ◽  
Patricia O’Campo ◽  
Aisha Lofters ◽  
Ketan Shankardass ◽  
Christina Salmon ◽  
...  
Keyword(s):  
Health Care ◽  
Concept Mapping ◽  
Health Care System ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Institutional Racism ◽  
Care Providers ◽  
Racial Ethnic ◽  
Care System

Abstract Background In Canada, there is longstanding evidence of health inequities for racialized groups. The purpose of this study is to understand the effect of current health care policies and practices on racial/ethnic groups and in particular racialized groups at the level of the individual in Toronto’s health care system. Methods This study used a semi-qualitative study design: concept mapping. A purposive sampling strategy was used to recruit participants. Health care users and health care providers from Toronto and the Greater Toronto Area participated in all four concept mapping activities. The sample sizes varied according to the activity. For the rating activity, 41 racialized health care users, 23 non-racialized health care users and 11 health care providers completed this activity. The data analysis was completed using the concept systems software. Results Participants generated 35 unique statements of ways in which patients feel disrespect or mistreatment when receiving health care. These statements were grouped into five clusters: ‘Racial/ethnic and class discrimination’, ‘Dehumanizing the patient’, ‘Negligent communication’, ‘Professional misconduct’, and ‘Unequal access to health and health services’. Two distinct conceptual regions were identified: ‘Viewed as inferior’ and ‘Unequal medical access’. From the rating activity, racialized health care users reported ‘race’/ethnic based discrimination or everyday racism as largely contributing to the challenges experienced when receiving health care; statements rated high for action/change include ‘when the health care provider does not complete a proper assessment’, ‘when the patient’s symptoms are ignored or not taken seriously’, ‘and ‘when the health care provider belittles or talks down to the patient’. Conclusions Our study identifies how racialized health care users experience everyday racism when receiving health care and this is important to consider in the development of future research and interventions aimed at addressing institutional racism in the health care setting. To support the elimination of institutional racism, anti-racist policies are needed to move beyond cultural competence polices and towards addressing the centrality of unequal power social relations and everyday racism in the health care system.

Ethnicity as a Factor

2015 ◽  
Author(s):  
Kimberly S. Johnson ◽  
Ramona L. Rhodes
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
African Americans ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Ethnic Disparities ◽  
Care Providers ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care

This chapter examines how race or ethnicity affects access to, and the quality of, palliative care by focusing on the experience of African Americans and Hispanics. More specifically, it considers how cultural beliefs, values, and preferences may influence care. It begins by looking at racial and ethnic disparities that exist throughout the health-care continuum, from disease prevention, early diagnosis, and curative treatment, to communication and pain management, lower rates of advance care planning, and lower utilization of hospice and palliative care services. It then explores the preferences of African Americans and Hispanics when it comes to end-of-life care, as well as the role of spirituality and faith in how they cope with illness. The chapter concludes by suggesting strategies and future directions for health-care providers, organizations, policymakers, and researchers on how to improve care for patients of diverse racial and ethnic backgrounds.

scholarly journals Improving Behavioral Health Equity through Cultural Competence Training of Health Care Providers

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Integrated Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Ethnic Disparities ◽  
The United States ◽  
Care Providers ◽  
Care Needs

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359

How do we die?

2016 ◽  
Vol 35 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Bonnie Stabile ◽  
Aubrey Grant
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Hospice Care ◽  
Good Reason ◽  
The Elderly ◽  
The United States ◽  
Medical Intervention ◽  
Current Approach ◽  
Physician Assisted Suicide ◽  
Policy And Practice

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers’ final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring “death with dignity” cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome — despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

A Systems Approach to Training Potential Communication Partners of People With Aphasia

2013 ◽  
Vol 22 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Nina Simmons-Mackie
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Systems Approach ◽  
High Tech ◽  
Care Providers ◽  
Policy And Practice ◽  
Evidence Based Practices ◽  
Direct Training ◽  
Communication Partners ◽  
Communication Partner Training

Abstract Experts have recommended communication partner training as an effective method of improving skills of communication partners and supporting communication of people with aphasia (Simmons-Mackie, Raymer, Armstrong, Holland & Cherney, 2010). Such training involves learning about aphasia, types of communication supports (e.g., low-tech, high-tech), and strategies for facilitating communication. Although much of this literature addresses the training of regular, familiar partners, there is evidence that “potential” communication partners can be trained to support communication with unfamiliar people with aphasia (e.g., training health care providers to communicate with patients with aphasia). However, direct training sessions with potential partners does not ensure that partners will implement these support practices in day-to-day activities in organizations such as those associated with health care, government, or business. Rather, experts must take a systems approach if communication support is to be supported by and included in organizational policy and practice. In this article, I describe a systems approach to implementing evidence-based practices in organizations.

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