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Description of the questionnaire Description of two hypothetical persons, e.g. Isa, 25 years old and born in Sweden, and Urgesa, 45 years old and born outside Europe. For each person the following questions are asked:
Source publication
Background:
Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an...
Citations
... Moreover, in health care, such communication can define interactions between practitioners and patients with diverse cultural background [2][3][4][5]. This intercultural and interacting health care setting can instigate specific challenges, especially as these interactions can threaten equity in health care [6][7][8]. Literature features quite some variance in how equity in health care is described [9]. Lane and colleagues reviewed this equity literature and suggested a practically operationalized definition of equity in health care depending on the specific application [10]. ...
Why does someone thrive in intercultural situations; while others seem to struggle? In 2014, Leung and colleagues summarized the literature on intercultural competence and intercultural effectiveness into a theoretical framework. This integrative framework hypothesizes that the interrelations between intercultural traits, intercultural attitudes and worldviews, and intercultural capabilities predict the effectiveness with which individuals respond to intercultural situations. An empirically verified framework can contribute to understanding intercultural competence and effectiveness in health care workers, thus contributing to more equity in health care. The present study sets out to test this integrative framework in a specific health care context. Future health care practitioners (N = 842) in Flanders (Belgium) were questioned on all multidimensional components of the framework. Structural equation modeling showed that our data were adequate to even a good fit with the theoretical framework, while providing at least partial evidence for all hypothesized relations. Results further showed that intercultural capabilities remain the major gateway toward more effective intercultural behavior. Especially the motivation and cognition dimensions of cultural intelligence seem to be key factors, making these dimensions an excellent target for training, practical interventions, and identifying best practices, ultimately supporting greater intercultural effectiveness and more equity in health care.
... The survey was pilot tested on a small group of university teachers in healthcare educations, and some alterations were thereafter made to enhance clarity. Furthermore, the survey had been used in several previous studies on nursing students and telephone nurses [16,36,37]. Because of the telephone nursing context, three aspects of intersectionality were chosen: age, ethnicity and sex, because telephone nurses mostly know these when a healthcare telephone call is made. ...
... The present results do not tell if the nursing teachers thought these issues were important or whether they permeated their teaching. Awareness could, at its best, be a step in the chain towards actions, as previously described [37]. There could, however, be a fine line between awareness and prejudice. ...
Background
Nursing care should be respectful of and unrestricted by patients’ age, ethnicity, gender, dis/abilities or social status, and such values should be taught to nursing students. Nursing teachers are crucial as role models, and their values are essential. In telephone nursing, only age, sex and ethnicity are known to the registered nurses, which can be challenging. The aim of this study was to explore awareness of discrimination and inequity in telephone nursing among nursing teachers.
Methods
A study specific survey was filled in by 135 nursing teachers from three universities in Sweden. The survey included short descriptions of 12 fictive persons who differed in age, ethnicity and sex and with questions about their estimated life situation. The teachers’ estimations of life situation were ranked from lowest probability to highest probability. A ‘good life index’ was constructed and calculated for each fictive person. It included quality of life, power over one’s own life and experience of discrimination.
Results
The results indicate that the nursing teachers were aware of how power and age, ethnicity and sex are related; that is, they were aware of discrimination and inequity in healthcare. The persons assessed to be most likely to lead a good life were males of Swedish origin, followed by females of Swedish origin. Persons with non-European origin were estimated to have the highest probability of experiencing discrimination.
Conclusions
The nursing teachers were aware of discrimination and inequity in healthcare. They were able to estimate a fictive person’s life situation based on the limited knowledge of age, ethnicity and sex. This is important, as their values are pivotal in theoretical and practical nursing education.
... In a previous study, we developed a conceptual model for attaining equity in healthcare [37], since tools for assessing (in)equity in healthcare are scarce. The model emerged from empirical data on SHD telephone RNs' views on equity in healthcare, and includes the concepts Denial, Defence, Openness, Awareness, and Action; see Fig. 1. ...
... Individuals can thus develop and mature and, consequently, go from Denial, via Defence and Openness, to Awareness. Furthermore, to make a change and achieve equity in healthcare, Action is needed [37]. Different contexts and circumstances can possibly make an individual advance to new positions on the continuum. ...
... A combination of the two interpretations described above is presented in our earlier study [37]. The categories Denial and Defence were argued to be qualitatively different in character from Openness and Awareness. ...
Background:
Although Swedish legislation prescribes equity in healthcare, inequitable healthcare is repeatedly reported in Sweden. Telephone nursing is suggested to promote equitable healthcare, making it just one call away for anyone, at any time, irrespective of distance. However, paediatric health calls reflect that male parents are referred to other health services twice as much as female parents are. Regarding equity in healthcare, telephone nurses have expressed a continuum from Denial and Defence to Openness and Awareness. To make a change, Action is also needed, within organizational frames. The aim here was thus to investigate Swedish Healthcare Direct managers' views on gender (in)equity in healthcare through the application of a conceptual model, developed based on empirical Swedish Healthcare Direct telephone RN data, as a baseline measure at the service's national implementation.
Methods:
All Swedish Healthcare Direct managers were interviewed during the period March-May 2012. They were asked how they view equitable healthcare, and how they work to achieve it. A conceptual model for attaining equity in healthcare, including Denial, Defence, Openness, Awareness and Action, was used in a deductive thematic analysis of the interview data.
Results:
The five model concepts - Denial; Defence; Openness; Awareness and Action - were found in a variety of combinations in the manager interviews. Denial and Defence were mentioned to a higher extent than Openness and Awareness. Several informants denied inequity, arguing that the decision support tool prevented this. However, those who primarily expressed Denial and Defence were also open to learning more on the subject. Action was only mentioned twice in the informants' answers, and then only implicitly.
Conclusion:
Although a majority of the interviewed managers expressed a lack of awareness of (in)equity in healthcare, they also expressed an openness to learning more. While this may reflect a desire to show political correctness, it also points to the need for educational training in order to increase the awareness of (in)equity in healthcare among healthcare managers. Future follow up measurements will reveal if this has happened.
... Home care is a female-dominated sector (Lyon & Glucksmann, 2008), and many older people receiving home care are also female (Hellström, Persson, & Hallberg, 2004). In Sweden, equity in health care is emphasized in the Healthcare Act (Government Offices of Sweden, 1982), yet there is divergence among healthcare professionals on acknowledging inequity in healthcare settings (Höglund, Carlsson, Holmström, Lännerström, & Kaminsky, 2018). Nurses working in home care settings also care for older populations remaining in their homes to an increasing extent later in life. ...
The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio‐recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65–84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.
Background: Health equity is “people access and utilization of healthcare services according to the needs, paying for healthcare based on financial ability and having an acceptable level of health”. Hospital beds are the major health system inputs and their equitable distribution is critical in achieving universal health coverage. The purpose of this study was to evaluate equity in the geographical distribution of hospital beds in Khuzestan Province, Iran in 2016.
Materials and Methods: Data for this descriptive and cross sectional study were derived from the Ministry of Health and Iranian statistics center. The study population consisted of all Khuzestan province hospitals in 2016. The equity in the distribution of hospital beds was measured using the Lorenz curve and the Gini coefficient. Excel software was used for data analysis.
Results: Khuzestan province had a population of 4,710,509, and 54 hospitals with 7,014 beds in 2016. There was 1.1 hospitals per 100,000 people and 1.5 hospital beds per 1000 people in this province. Ahwaz, Karun and Masjed Soleiman counties have had the highest hospital beds per 1000 people. Ahvaz County, the capital, had 30% of the province hospitals and 51% of the total hospital beds. The Gini coefficient was 0.33 for hospital bed distribution among Khuzestan counties.
Conclusion: The distribution of hospital beds in Khuzestan province has been relatively fair. Healthcare policymakers should act appropriately to reduce inequality in the distribution of hospital beds in deprived counties and cities.
Mosadeghrad AM, Dehnavi H, Darrudi A. Equity in geographical distribution of hospital beds in Khuzestan Province. EBNESINA. 2020; 22 (2) :44-55
