Representation and reporting of communicatively vulnerable patients in patient experience research

PURPOSE: To apply a human rights lens to measuring patient experience. Specifically, to determine if the perspectives of communicatively vulnerable people have been included in the patient experience research used to inform the development of the Australian Hospital Patient Experience Question Set (AHPEQS). METHOD: Thirty-nine qualitative studies on patient experience that informed the development of AHPEQS were critically appraised in terms of reporting on: population of interest, eligibility criteria, communicative demands of the research and communicative supports provided. RESULT: Eleven of 39 studies included sufficient information about the population to determine that communicatively vulnerable people would have been approached to participate. Three of these studies explicitly excluded people who were communicatively vulnerable, and four did not report on the provision of any communication supports to enable communicatively vulnerable people to participate. CONCLUSION: Intentional exclusion and/or a lack of communication supports restrict the rights of people who are communicatively vulnerable to express their opinions about what matters to them in hospital. Inadequate reporting of qualitative research on patient experience also makes it difficult to determine if the perspectives of people who are communicatively vulnerable have informed the development of the AHPEQS

The neglect of racism as an ethical issue in health care

Race and racism has been increasingly implicated in known disparities in the health and health care of racial, ethnic and cultural minorities groups. Despite the obvious ethical implications of this observation, racism as an ethical issue per se has been relatively neglected in health care ethics discourse. In this paper consideration is given to addressing the following questions: What is it about racism and racial disparities in health and health care that these command our special moral scrutiny? Why has racism per se tended to be poorly addressed as an ethical issue in health care ethics discourse? And why, if at all, must racism be addressed as an ethical issue in addition to its positioning as a social, political, cultural and legal issue? It is suggested that unless racism is reframed and redressed as a pre-eminent ethical issue by health service providers, its otherwise preventable harmful consequences will remain difficult to identify, anticipate, prevent, manage, and remedy. <br /

Integrating socio-cultural paradigms in nonprofit marketing - the case of blood donation among African communities in Australia

This paper examines how nonprofit marketers need to integrate socio-cultural factors when targeting minorities, using blood donation issues among African communities in Australia as an example. We start with an overview of the significance of African communities to Australia. Then blood donation patterns among migrant populations are discussed as well as the cultural beliefs about blood in the African continent and the intergenerational complexities that can arise between older and younger migrant donors. Marketing intervention models that seek to increase blood donation need to consider two factors: (1) geographical and generational cultural differences, that is, in relation to home and host country beliefs; and (2) intergenerational (young people vs. parents) differences in and attitudes to blood donation, especially when young people adopt the values of the host country faster than older migrants. Accounting for these cultural differences will enable non-profit and social services to develop culturally-competent marketing strategies to better meet the needs of different migrant communities. © 2010 Springer-Verlag