HASTANE ÇALIŞANLARININ HASTALARA YÖNELİK AYRIMCI TUTUM VE DAVRANIŞLARI ÜZERİNE BİR ARAŞTIRMA

Öz

Ayrımcılık; eşit muameleyi hak eden bireylere yasal bir sebebe dayandırılmadan farklı muamelede bulunulmasıdır. Eğer bu farklı muameleye maruz kalan kişi bir hastaysa hasta ayrımcılığı ortaya çıkmaktadır. Bu çalışmada sağlık çalışanlarının hastalar arasında çeşitli sebeplerden dolayı ayrımcılık yapıp yapmadığının tespiti hedeflenmiştir. Ayrımcı davranışların mülkiyetine göre hangi hastanelerde, hangi sağlık çalışanı tarafından daha fazla yapıldığı ve ayrımcı davranışlara temel oluşturan gerekçelerin neler olduğu araştırılmıştır. Çalışmanın evrenini çalışmanın yapıldığı süreçte Isparta il merkezinde bulunan 18-65 yaş arası bireyler oluşturmaktadır. Araştırma kapsamında 535 kişiye ulaşılmıştır. Araştırmada veri toplama aracı olarak literatür taraması yapılarak geliştirilen Ayrımcılık Tecrübesi Anketi kullanılmıştır. Araştırmanın sonuçları; katılımcıların %26’sının negatif ayrımcılığı tecrübe ettiklerini, katılımcıların sırasıyla en çok fiziksel görünüşü (kılıkkıyafet), mesleği, geliri ve yaşı ayrımcılık sebebi olarak gördüklerini, düşük sosyal statülü bireylerin daha çok ayrımcılığa maruz kaldıklarını, ayrımcı davranışların en çok hemşireler ve hekimler tarafından sergilendiğini ve yine ayrımcı tutumların en çok devlet hastanelerinde görüldüğünü ortaya koymuştur

Anahtar Kelimeler

• ayrımcılık, hasta ayrımcılığı, sağlık çalışanları

A RESEARCH ON DISCRIMINATIVE ATTITUDES AND BEHAVIOUR OF HOSPITAL STAFF DIRECTED TO PATIENTS

Abstract

Discrimination is (defined as) treating individuals who deserve equal treatment differently, without any legal ground. If this person who is subjected to different treatment is a patient, what results is patient discrimination. In this study, determination of hospital staff’s discriminative attitudes toward patients was aimed. . (More specifically) Which types of hospitals (publicly or privately owned), and which category of healthcare workers display discriminative attitudes more, and the reasons for these attitudes are studied. This study was done on 535 people from 18-65 years old in center of Isparta. In this study, discrimination experience survey is formed with help of literature was used. According to study; %26 of paticipants have negative discrimination experimets because of physical apperance, occupation, income, age and low social status. Usually nurses and physicians have discriminative attitudes and these attitudes are experienced in goverment hospitals frequently

Keywords

• Discrimination, patient discrimintion, hospital staff

References

1. AKBOLAT, M. ve O. Işık, (2008), “Sağlık Çalışanlarının Tükenmişlik Düzeyleri: Bir Kamu Hastanesi Örneği”, Hacettepe Sağlık İdaresi Dergisi, Ankara, Cilt 11, Sayı 2, ss. 230-254.
2. BENLİ, F., S. Özdoğan ve H. Atabey, (2011), “Başörtüsü Yasağı ve Ayrımcılık Raporu”, İnsan Hakları ve Mazlumlar için Dayanışma Derneği, Ankara.
3. BIRD, S. T., L. M. Bogart and D. L. Delahanty, (2004), “Health-Related Correlates of Perceived Discrimination in HIV Care”, AIDS Patient Care Sexually Transmitted Diseases, Vol.: 18, Issue 1, pp. 19–26.
4. BOBO L. D. and C. Fox, (2003), “Race, Racism, and Discrimination: Bridging Problems, Methods, and Theory in Social Psychological Research”, Social Psychology Quarterly, Vol.: 66, Issue 4, pp. 319–322.
5. BORRELL, C. vd., (2010), “Perceived Discrimination and Health by Gender, Social Class, and Country of Birth in a Southern European Country”, Preventive Medicine, Vol.: 50, Issue 1-2, pp. 86-92.
6. BORRELL, L.N. vd., (2007), “Self-reported Racial Discrimination and Substance Use in The Coronary Artery Risk Development in Adults Study”, American Journal of Epidemiology, Vol.: 166, Issue 9, pp. 1068–1079.
7. BRYANT, K. and S. Vidal-Ortiz, (2008), “Introduction to Retheorizing Homophobias”, Sexualities, Vol.: 11, Issue 4, pp. 387-396.
8. BURGESS D. J. vd., (2008), “The Association Between Perceived Discrimination and Underutilization of Needed Medical and Mental Health Care in A Multi-Ethnic Community Sample”, Journal of Health Care for The Poor Underserved, Vol.: 19, Issue 3, pp. 894– 911.

9. CİNDOĞLU, D., (2010), Başörtüsü Yasağı ve Ayrımcılık: İş Hayatında Meslek Sahibi Başörtülü Kadınlar, İstanbul, TESEV Yayınları. COLLINS, C. A., (1999), “Racism and Health: Segregation and Causes of Death Amenable to Medical Intervention in Major U.S. Cities”, Annals of the New York Academy of Sciences, Volume 896, pp. 396– 398.
10. COLLINS, J. W. vd., (2004), “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination”, American Journal of Public Health, Vol.: 94, Issue 12, pp. 2132–2138.
11. CUNNINGHAM, T. J. vd., (2011), “Assesment of Differantial Item Functioning in the Experiences of Discrimination Index The Coonary Artery Risk Devolopment In Young Adult (CARDIA) Study”, American Journal of Epidemiology, Vol.: 174, Issue 11, pp. 1266- 1274
12. DIN-DZIETHAM, R. vd., (2004), “Perceived Stress Following Raced-based Discrimination at Work is Associated with Hypertension in AfricanAmericans. The Metro Atlanta Heart Disease Study, 1999-2001”, Social Science and Medicine, Vol.: 58, Issue 3, pp. 449–461.
13. DOMINGO-SALVANY, A. vd., (2000), “Proposal for a Social Class Measure. Working Group of the Spanish Society of Epidemiology and the Spanish Society of Family and Community Medicine”, Atencion Primaria, Vol.: 25, Issue 5, pp.350–363.
14. DUBOIS-ARBER, F., vd., (2001), “HIV/AIDS Institutional Discrimination in Switzerland”, Social Science & Medicine, Vol.: 52, Issue 10, pp.1525-1535.
15. FORMAN, T. A., (2003), “The Social Psychological Costs of Racial Segmentation in the Workplace: a Study of African Americans' Wellbeing”, Journal of Health and Social Behavior, Vol.: 44, Issue 3, pp. 332–352.
16. GRUSKIN, S., A. Hendriks and K. Tomasevski, (1996), Human Rights and Responses to HIV/AIDS, in AIDS in the World II, Edited by Mann, J. and D. Tarantola, Oxford University Press, New York.
17. HARRIS, R. vd., (2006), “Racism and Health: The Relationship Between Experience of Racial Discrimination and Health in New Zealand”, Social Science & Medicine, Vol.: 63, pp. 1428–1441.
18. HAUSMANN, L. R. M. vd., (2008),” Perceived Discrimination in Health Care and Health Status in a Racially Diverse Sample”, Medical Care, Vol.: 46, Issue 9, pp. 905-914.
19. HOFSTEDE, G., (2001), Cultures Consequences, Second Edition, Sage Publications, London. http://www.secbir.org/wp-content/uploads/2011/01/02-MELEKGOREGENLI-1.pdf Erişim Tarihi: 16. 12. 2013.
20. HUDELSON, P., V. Kolly and T. Permeger, (2009), Patients’ Perceptions of Discrimination During Hospitalization, Health Expectations, Volume 13, Issue 1, pp. 24-32.
21. HUMAN RIGHTS COMMISSION, (2004), Human Rights in New Zealand Today, Wellington: Human Rights Commission. JACKSON, S. A. vd., (2000), “The Relation of Residential Segregation to Allcause Mortality: A Study in Black and White”, American Journal of Public Health, Vol.: 90, Issue 4, pp. 615–61-517
22. JENKINSON, C., A. COULTER and S. BRUSTER, (2002), “The Picker Patient Experience Questionnaire: Development and Validation Using Data from In-Patient Surveys in FiveCountries”, International Journal of Quality in Health Care, Vol.: 14, Issue 5, pp. 353-358. JONES, C. P., (2001), “Invited Commentary: ‘‘Race,’’ Racism, and the Practice of Epidemiology”, American Journal of Epidemiology, Vol.: 154, Issue 4, pp. 299–304.
23. KAN, İ., (1998), Biyoistatistik, Bursa, Uludağ Üniversitesi Basımevi.
24. KARLSEN, S. and J. Y. Nazroo, (2004), “Fear of Racism and Health”, Journal of Epidemiology and Community Health, Vol.: 58, pp. 1017– 1018.
25. KARLSEN, S. vd., (2005), “Racism, Psychosis and Common Mental Disorder Among Ethnic Minority Groups in England”, Psychological Medicine, Vol.: 35, Issue 12, pp. 1795–1803.
26. KARLSEN, S., and J.Y. Nazroo, (2002), “Relation Between Racial Discrimination, Social Class, and Health Among Ethnic Minority Groups”, American Journal of Public Health Vol.: 92, Issue 4, pp. 624–631.
27. KELAHER, M. vd., (2008), “Discrimination and Health in an English Study”, Social Science & Medicine, Vol.: 66, Issue 7, pp. 1627–1636. KÖSE, Ş. vd., (2011), “The Social and Health Problems of People Living with HIV/AIDS in Izmir”, Turkey, The Eurasian Journal of Medicine, Vol.: 44, pp. 32-39.
28. KRIEGER N. vd., (2005), “Experiences of Discrimination : Validity and Reliability of a Self-Report Measure for Population Health Research on Racism and Health”, Social Science & Medicine, Vol.: 61, Issue 7, pp. 1576-1596.
29. KUKURA, E., (2005), “Sexual Orientation and Non-Discrimination”, Peace Review: A Journal of Social Justice, Vol.:1, Issue 2-3, pp.181-188.
30. LEWIS, T. T. vd., (2012), “Racial/Ethnic Differences in Responses to the Everyday Discrimination Scale: a Differential Item Functioning Analysis”, American Journal of Epidemiology, Vol.:175, Issue 5, pp. 391-401.
31. MANN, J., (1987), Statement at an Informal Briefing on AIDS to the 42nd Session of the United Nations General Assembly, 20 October, New York.
32. MUSTILLO, S. vd., (2004), “Self-reported Experiences of Racial Discrimination and Black-White Difference in Preterm and Lowbirthweight Deliveries: The CARDIA Study”, American Journal of Public Health, Vol.: 94, Issue 12, pp. 2125–2131.
33. NOH, S. and V. Kaspar, (2003), “Perceived Discrimination and Depression: Moderating Effects of Coping, Acculturation and Ethnic Support”, American Journal of Public Health, Vol.: 93, Issue 2, pp. 232–238.
34. PARADIES, Y., (2006), “A Systematic Review of Empirical Research on Self-reported Racism and Health”, International Jornal of Epidemiology, Vol.: 35, Issue 4, pp. 888–901.
35. PARK, J. H. vd., (2010), “Changes in Employment Status and Experience of Discrimination Among Cancer Patients: Findings From a Nationwide Survey in Korea”, Psycho-Oncology, Vol.: 19, Issue 12, pp.1303- 1312.
36. PASCOE, E.A. and L. Smart Richman, (2009), “Perceived Discrimination and Health: a Meta-analytic Review”, Psychological Bulletin, Vol.: 135, Issue 4, pp. 531–554.
37. PIETTE, J. D., K. Bibbins-Domingo and D. Schillinger, (2006), “Health Care Discrimination, Processes of Care, and Diabetes Patients Health Status”, Patient Education and Counseling, Vol.: 60, Issue 1, pp. 41– 48.
38. ROBERTS, K. J. (2002), “Physician-Patient Relationships, Patient Satisfaction, and Antiretroviral Medication Adherence Among HIVInfected Adults Attending a Public Health Clinic”, AIDS Patient Care STDS, Vol.: 16, Issue 1, pp. 43-50.
39. STEPANIKOVA, I. and K. S., Cook (2008), “Effects of Poverty and Lack of Insurance on Perceptions of Racial and Ethnic Bias in Health Care”, Health Services Research, Vol.: 43, Issue 3, pp. 915-930
40. T.C Sağlık Bakanlığı (2013), T.C Sağlık Bakanlığı HIV/AIDS Veri Tabloları http://pozitifyasam.org/assets/files/Turkiyeverileri_Haziran_2013.pd f, Erişim Tarihi: 02.12.2013.
41. TAUER, C. A., (1989), “AIDS: Human Rights and Public Health”, Medical Anthropology, Vol.: 10, Isue 2-3, pp. 177–192.
42. TAYCAN, O., vd, (2006), Bir Üniversite Hastanesinde Çalışan Hemşirelerde Depresyon ve Tükenmişlik Düzeyinin Sosyodemografik Özelliklerle İlişkisi, Anadolu Psikiyatri Dergisi, Cilt 7, ss. 100-108
43. TURNER, S. T., (2011), Tıbbi Güç ve Toplumsal Bilgi, Çev: Tatlıcan, Ü., Bursa, Sentez Yayıncılık.
44. WANG, Y., K. Zhang and K. Zhang, (2008), “HIV/AIDS Related Discrimination in Health Care Service: A Cross-sectional Study in Gejiu City, Yunnan Province”, Biomedical and Environmental Sciences, Vol.: 21, pp. 124-128.
45. WIKING, E., S. Johansson and J. Sundquist, (2004), “Ethnicity, Acculturation, and Self Reported Health. A Population Based Study Among Immigrants from Poland, Turkey, and Iran in Sweden”, Journal of Epidemiology and Community Health, Vol.: 58, Issue 7, pp. 574–582.
46. WILLIAMS, D. R. and S. A. Mohammed, (2009), “Discrimination and Racial Disparities in Health: Evidence and Needed Research”, Journal of Behavioral Medicine, Vol.: 32, Issue 1, pp. 20–47.