Exploring women's health care experiences through an equity lens: Findings from a community clinic serving marginalised women

Abstract

Aims and objectives To explore how marginalised women perceive and rate equity‐oriented health care at a primary care clinic using items that evaluate patients' experiences of care. Background Despite an increased recognition of the importance of health care that is equity‐oriented, and that understands the patient within the context of the broader social determinants of health, inequities in health remain prevalent around the world. Design Items from the “EQUIP Primary Health Care" research programme were used to explore patients' experiences of equity‐oriented health care. Women were invited to complete the questionnaire with the explicit aim of gaining their input to improve quality of care at the clinic. The Strengthening the Reporting of Observational Studies in Epidemiology Statement was followed for the study. Methods Sixty‐seven women who experienced significant health and social inequities, and were seeking care at a women's only nurse practitioner primary health care clinic in Canada, were invited to complete the questionnaire. For quality improvement purposes, correlational analyses were used to explore women's experiences of care. Results Women's responses showed that Promote Emotional Safety and Trust and Overall Quality of Care were the most highly correlated domains, indicating the importance of the health care team in establishing trusting relationships, particularly for women who experience stigma and negative judgement when seeking care. Conclusion Seeking feedback from patients on their experiences of care using items developed to explicitly tap into equity issues is useful in understanding how patients experience equity‐oriented health care. Responses from the women highlight the importance of understanding not only the what of equity‐oriented care but also the how. Relevance to clinical practice The results of this study illustrate the importance of establishing trusting relationships, tailoring care, and using a nondiscriminatory approach when working with women who experience negative judgements when seeking care.

Indicators of Good Nursing Practices for Vulnerable Groups in Primary Health Care: A Scoping Review

“…The studies included in this review showed the range of people in a situation of social vulnerability assisted by Nursing. With regard to age, studies involving adults ( 16 - 17 , 19 , 21 , 23 - 25 ) , older adults ( 18 , 22 , 27 ) , children ( 15 ) and adolescents ( 20 ) stood out; regarding gender, there was predominance of studies involving women ( 16 - 17 , 21 , 23 - 24 ) ; and, regarding race/ethnicity, of studies associated with the Aboriginal ( 21 ) and African-American ( 26 ) population.…”

“…In addition to that, they took into account the individual context, life history, experience, and family support. The assessment of needs fulfillment was carried out through home visits and hospitalizations, mainly through Sensitive Conditions to Primary Health Care (SCPHC) ( 15 , 18 - 19 , 21 - 23 , 25 , 27 ) .…”

“…The fifth category involved the users’ relationship with the health services, highlighting accessibility, welcoming, empathy, trust, non-discriminatory posture, strengthening the bond and recognizing the barriers that may influence the care and monitoring of health needs ( 17 - 19 , 23 - 27 ) .…”

“…In the sixth category, indicators that sought to assess the care process through the perspective about quality, outcome measures and the positive, negative and beneficial aspects of the interventions to meet health needs were included ( 16 , 20 , 23 , 27 ) .…”

Práticas de enfermagem í s mulheres que vivenciaram aborto: revisão integrativa

“…Nessa perspectiva, os estudos descortinam a necessidade de que a categoria profissional deva lutar para assegurar acessibilidade à assistência qualificada, equitativa e humanizada às mulheres afetadas pelo aborto, independente de sua raça/cor, classe social ou faixa etária (20) . Em países onde essa assistência é assegurada e/ou o aborto é legalizado, outros aspectos da atenção às mulheres têm sido objeto de estudos, tais como: o direito de visualizar os produtos da concepção (30) , o acesso equitativo de mulheres marginalizadas (31) , e o aborto medicamentoso por meio da telemedicina (32) .…”