Patients with disabilities report feeling disrespect from health care professionals
A study of U.S. survey data found that people with disabilities were less likely to say that their clinicians treated them with respect, asked their opinions about their care, and gave them easily understood information.
Patients with disabilities were more likely than those without disabilities to report negative experiences with health care professionals, a study found.
Researchers analyzed data from a cross-sectional household survey of adult participants in the 2017 National Health Interview Survey and compared perceptions of culturally responsive care among people with and without disabilities. They then stratified results by disability type. All participants had seen a health care professional in the prior year and were asked questions about the professional's “cultural competence,” or how the professional treated them and engaged them in their care. Responses to three 4-point Likert scale questions were dichotomized into positive (“always/most of the time”) and negative (“some/none of the time)” and were used to assess patient perceptions of whether health care professionals treated them with respect, solicited their opinions and beliefs, and provided easy-to-understand information. The results were published as a brief research report on March 4 by Annals of Internal Medicine.
The study included 22,864 patients who had been asked questions about their clinician's cultural competence; of these, 9,919 had disabilities. The latter group tended to be older, were more likely to be never or previously married, were more likely to not be in the labor force, and had lower family incomes and poorer self-reported health. Compared with people without disabilities, those with them were less likely to report receiving culturally responsive care from clinicians regarding being treated with respect (risk difference, −1.8; 95% CI, −2.8 to −0.9), being asked for their opinions about their care (risk difference, −3.8; 95% CI, −6.0 to −1.6), or being given easily understood information (risk difference, −4.2; 95% CI, −5.6 to −2.9).
Those with all types of disabilities were less likely to report receiving easily understood information, particularly those with vision, hearing, and cognitive disabilities, and all participants with disabilities except those with mobility-related disabilities also reported being less likely to be treated with respect. In addition, those with psychological, vision, and hearing disabilities were less likely to report receiving culturally responsive care across the three questions.
The study findings highlighted the need to broaden the concept of culturally responsive care to include disabilities that are not immediately visible, the authors wrote. Future research should explore “the effect of interventions involving not only clinician-level training but also system-level policies that enable or incentivize [health care professionals] to provide disability-responsive care,” they concluded.