Nicole Agaronnik1, Eric G Campbell2, Julie Ressalam3, Lisa I Iezzoni4. 1. Mongan Institute Health Policy Center, Massachusetts General Hospital, United States. Electronic address: nagaronnik@mgh.harvard.edu. 2. Center for Bioethics and Humanities, University of Colorado School of Medicine, United States. Electronic address: ERIC.G.CAMPBELL@ucdenver.edu. 3. Center for Bioethics and Humanities, University of Colorado School of Medicine, United States. Electronic address: JULIE.RESSALAM@ucdenver.edu. 4. Mongan Institute Health Policy Center, Massachusetts General Hospital, United States; Department of Medicine, Harvard Medical School, United States. Electronic address: liezzoni@mgh.harvard.edu.
Abstract
BACKGROUND: Many factors contribute to the well-recognized health care disparities experienced by persons with disability, including failure of physicians to understand the lives of individuals with disability. Disability cultural competence considers physicians' ability to meet the social, cultural, and linguistic needs of this population. OBJECTIVES: To assess physicians' understanding of disability cultural competence and attitudes towards patients with disability. METHODS: Qualitative analyses of open-ended individual interviews averaging 41 min with 20 Massachusetts physicians from 5 different subspecialties, in practice for 8-51 years. Interview recordings were transcribed verbatim for conventional content analysis. RESULTS: Most participants defined disability using medically-focused concepts rather than concepts that recognize how social factors contribute to disability. All participants used disability culturally-competent language, such as "person-first language," at some points throughout their interviews. However, most participants also employed language that is now considered unacceptable or archaic, such as variations on the word "handicap," "wheelchair-bound," describing persons with disability as "suffering," and calling persons by their health condition (e.g., "COPDer"). Participants mentioned persons with mental illness and intellectual disability as particularly challenging, especially around communication and performing even routine tests or examinations. Recommendations for improving care included better listening to patients with disability and seeking their views about their care. CONCLUSIONS: In this exploratory study, most participants used language that is considered disability culturally competent at times but also employed many terms and concepts that are considered outdated and may be troubling to some persons with disability.
BACKGROUND: Many factors contribute to the well-recognized health care disparities experienced by persons with disability, including failure of physicians to understand the lives of individuals with disability. Disability cultural competence considers physicians' ability to meet the social, cultural, and linguistic needs of this population. OBJECTIVES: To assess physicians' understanding of disability cultural competence and attitudes towards patients with disability. METHODS: Qualitative analyses of open-ended individual interviews averaging 41 min with 20 Massachusetts physicians from 5 different subspecialties, in practice for 8-51 years. Interview recordings were transcribed verbatim for conventional content analysis. RESULTS: Most participants defined disability using medically-focused concepts rather than concepts that recognize how social factors contribute to disability. All participants used disability culturally-competent language, such as "person-first language," at some points throughout their interviews. However, most participants also employed language that is now considered unacceptable or archaic, such as variations on the word "handicap," "wheelchair-bound," describing persons with disability as "suffering," and calling persons by their health condition (e.g., "COPDer"). Participants mentioned persons with mental illness and intellectual disability as particularly challenging, especially around communication and performing even routine tests or examinations. Recommendations for improving care included better listening to patients with disability and seeking their views about their care. CONCLUSIONS: In this exploratory study, most participants used language that is considered disability culturally competent at times but also employed many terms and concepts that are considered outdated and may be troubling to some persons with disability.
Authors: Monika Mitra; Lauren D Smith; Suzanne C Smeltzer; Linda M Long-Bellil; Nechama Sammet Moring; Lisa I Iezzoni Journal: Disabil Health J Date: 2017-01-03 Impact factor: 2.554
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Authors: Claire Z Kalpakjian; Jodi M Kreschmer; Mary D Slavin; Pamela A Kisala; Elisabeth H Quint; Nancy D Chiaravalloti; Natalie Jenkins; Tamara Bushnik; Dagmar Amtmann; David S Tulsky; Roxanne Madrid; Rebecca Parten; Michael Evitts; Carolyn L Grawi Journal: J Womens Health (Larchmt) Date: 2020-05-19 Impact factor: 2.681
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Nicole D Agaronnik; Tara Lagu; Elizabeth Pendo; Eric G Campbell Journal: Health Aff (Millwood) Date: 2022-01 Impact factor: 6.301
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Nicole D Agaronnik; Karen Donelan; Tara Lagu; Eric G Campbell Journal: Health Aff (Millwood) Date: 2021-02 Impact factor: 6.301
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Karen Donelan; Nicole Agaronnik; Tara Lagu; Eric G Campbell Journal: Jt Comm J Qual Patient Saf Date: 2021-06-23