26 Culturally informed developmental paediatric care: A qualitative study
Notice bibliographique
Résumé
Abstract Background Paediatricians provide developmental care through developmental surveillance, identification and management of specific developmental disorders, and health advocacy. Despite being one of the most common reasons to visit a paediatrician, the provision of care in this field is challenging as it intersects with medical, mental health, and educational systems. Additionally, the rise of international migration, inequities in health systems, and unique culturally based concepts of child development require paediatricians to have unique skills for culturally informed care provision in this area. Objectives A qualitative study was conducted to describe the perceptions of paediatricians on providing culturally informed developmental paediatric care to diverse populations. Design/Methods Semi-structured interviews were completed with paediatricians who primarily provide developmental care to understand the challenges, opportunities, and potential educational enhancements to improve culturally informed care for developmental paediatrics. Thematic analysis was used to analyze the transcribed interviews using inductive and deductive approaches. Results Three major themes emerged from 18 individual semi-structured interviews. The first theme, “cultural translation,” described language differences, interpretation, and trust-building between discordant physician/family dyads. The second theme, “inequity,” described systemic barriers that diverse populations experience, power distance in healthcare relationships, and pandemic-related amplifications of inequity. The third theme, “educational opportunities,” highlighted reflective practice opportunities, immersive experiences in diverse settings, and building a community of practice for paediatricians to build their knowledge base. Paediatricians practicing developmental paediatric care highlighted unique elements to the practice which may benefit from practice changes and curricular reform. Integration of meaningful training in the use of interpretation services, multicultural health brokers, and care coordination teams is a recommended intervention which is transferable to many disciplines. Peer-mentorship from colleagues of differing cultural backgrounds may help reduce race-based stereotypes and enhance perspective taking. Conclusion Paediatricians had a variety of perspectives on the provision of developmental paediatric care to diverse populations within Canada. There were a range of perceived opportunities for improvements in care noted on individual and systems levels. The development of infrastructure to build capacity in culturally informed developmental paediatric care to reduce culturally based health gaps is a needed future direction for developmental paediatrics.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,011 | 0,010 |
| Communication savante | 0,005 | 0,003 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».