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Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study
BACKGROUND: Emergency departments (EDs) serve an integral role in healthcare, particularly for vulnerable populations. However, marginalized groups often report negative ED experiences, including stigmatizing attitudes and behaviours. We engaged with historically marginalized patients to better unde...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942657/ https://www.ncbi.nlm.nih.gov/pubmed/36809981 http://dx.doi.org/10.1186/s12873-023-00792-z |
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author | Bartels, Susan A. MacKenzie, Meredith Douglas, Stuart L. Collier, Amanda Pritchard, Jodie Purkey, Eva Messenger, David Walker, Melanie |
author_facet | Bartels, Susan A. MacKenzie, Meredith Douglas, Stuart L. Collier, Amanda Pritchard, Jodie Purkey, Eva Messenger, David Walker, Melanie |
author_sort | Bartels, Susan A. |
collection | PubMed |
description | BACKGROUND: Emergency departments (EDs) serve an integral role in healthcare, particularly for vulnerable populations. However, marginalized groups often report negative ED experiences, including stigmatizing attitudes and behaviours. We engaged with historically marginalized patients to better understand their ED care experiences. METHOD: Participants were invited to complete an anonymous mixed-methods survey about a previous ED experience. We analysed quantitative data including controls and equity-deserving groups (EDGs) - those who self-identified as: (a) Indigenous; (b) having a disability; (c) experiencing mental health issues; (d) a person who uses substances; (e) a sexual and gender minority; (f) a visible minority; (g) experiencing violence; and/or (h) facing homelessness - to identify differences in their perspectives. Differences between EDGs and controls were calculated with chi squared tests, geometric means with confidence ellipses, and the Kruskal-Wallis H test. RESULTS: We collected a total of 2114 surveys from 1973 unique participants, 949 controls and 994 who identified as equity-deserving. Members of EDGs were more likely to attribute negative feelings to their ED experience (p < 0.001), to indicate that their identity impacted the care received (p < 0.001), and that they felt disrespected and/or judged while in the ED (p < 0.001). Members of EDGs were also more likely to indicate that they had little control over healthcare decisions (p < 0.001) and that it was more important to be treated with kindness/respect than to receive the best possible care (p < 0.001). CONCLUSION: Members of EDGs were more likely to report negative ED care experiences. Equity-deserving individuals felt judged and disrespected by ED staff and felt disempowered to make decisions about their care. Next steps will include contextualizing findings using participants’ qualitative data and identifying how to improve ED care experiences among EDGs to make it more inclusive and better able to meet their healthcare needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-023-00792-z. |
format | Online Article Text |
id | pubmed-9942657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-99426572023-02-22 Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study Bartels, Susan A. MacKenzie, Meredith Douglas, Stuart L. Collier, Amanda Pritchard, Jodie Purkey, Eva Messenger, David Walker, Melanie BMC Emerg Med Research BACKGROUND: Emergency departments (EDs) serve an integral role in healthcare, particularly for vulnerable populations. However, marginalized groups often report negative ED experiences, including stigmatizing attitudes and behaviours. We engaged with historically marginalized patients to better understand their ED care experiences. METHOD: Participants were invited to complete an anonymous mixed-methods survey about a previous ED experience. We analysed quantitative data including controls and equity-deserving groups (EDGs) - those who self-identified as: (a) Indigenous; (b) having a disability; (c) experiencing mental health issues; (d) a person who uses substances; (e) a sexual and gender minority; (f) a visible minority; (g) experiencing violence; and/or (h) facing homelessness - to identify differences in their perspectives. Differences between EDGs and controls were calculated with chi squared tests, geometric means with confidence ellipses, and the Kruskal-Wallis H test. RESULTS: We collected a total of 2114 surveys from 1973 unique participants, 949 controls and 994 who identified as equity-deserving. Members of EDGs were more likely to attribute negative feelings to their ED experience (p < 0.001), to indicate that their identity impacted the care received (p < 0.001), and that they felt disrespected and/or judged while in the ED (p < 0.001). Members of EDGs were also more likely to indicate that they had little control over healthcare decisions (p < 0.001) and that it was more important to be treated with kindness/respect than to receive the best possible care (p < 0.001). CONCLUSION: Members of EDGs were more likely to report negative ED care experiences. Equity-deserving individuals felt judged and disrespected by ED staff and felt disempowered to make decisions about their care. Next steps will include contextualizing findings using participants’ qualitative data and identifying how to improve ED care experiences among EDGs to make it more inclusive and better able to meet their healthcare needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-023-00792-z. BioMed Central 2023-02-21 /pmc/articles/PMC9942657/ /pubmed/36809981 http://dx.doi.org/10.1186/s12873-023-00792-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Bartels, Susan A. MacKenzie, Meredith Douglas, Stuart L. Collier, Amanda Pritchard, Jodie Purkey, Eva Messenger, David Walker, Melanie Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title | Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title_full | Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title_fullStr | Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title_full_unstemmed | Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title_short | Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
title_sort | emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942657/ https://www.ncbi.nlm.nih.gov/pubmed/36809981 http://dx.doi.org/10.1186/s12873-023-00792-z |
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