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在全科医疗中文化相遇时:全科医生与儿童患者家长之间的文化差异

When cultures meet in general practice: intercultural differences between GPs and parents of child patients.

作者信息

Harmsen Hans, Meeuwesen Ludwien, van Wieringen Joke, Bernsen Roos, Bruijnzeels Marc

机构信息

Department of General Practice, Erasmus University Rotterdam, Room Ff 323, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.

出版信息

Patient Educ Couns. 2003 Oct;51(2):99-106. doi: 10.1016/s0738-3991(02)00195-7.

Abstract

Although health care professionals in The Netherlands are increasingly confronted with diverse immigrant groups, medical counselling and treatment of these groups has not been the subject of extensive research yet. From other studies it is well known that intercultural differences can have serious consequences for health care, e.g. in terms of risk of incorrect diagnoses or non-compliance. Eighty-seven autochthonous Dutch and immigrant (mainly from Turkey and Surinam) parents of child patients and their general practitioners (GPs) were recruited to investigate the influence of cultural differences on mutual understanding and patient compliance. Analyses of questionnaires and home interviews revealed that there is a relation between the cultural background of the patient and effectiveness of communication. Communication in consultations between GPs and persons from ethnic minorities is less effective than in consultations with Dutch persons: there is more misunderstanding, and also more non-compliance. In general, mutual understanding between GP and patient proves to be a strong predictor for patient compliance. These findings hold especially true for patients living in two worlds, i.e. a mixture of traditional and western cultures. The results are discussed in terms of methodological issues and practical implications for the health care providers.

摘要

尽管荷兰的医疗保健专业人员越来越多地面对不同的移民群体,但针对这些群体的医疗咨询和治疗尚未成为广泛研究的主题。从其他研究中可知,文化差异可能会给医疗保健带来严重后果,例如在错误诊断风险或不依从性方面。八十七位荷兰本土儿童患者的父母以及移民(主要来自土耳其和苏里南)儿童患者的父母及其全科医生(GP)参与了研究,以调查文化差异对相互理解和患者依从性的影响。对问卷和家庭访谈的分析表明,患者的文化背景与沟通效果之间存在关联。全科医生与少数族裔患者之间的会诊沟通效果不如与荷兰患者之间的会诊:误解更多,不依从情况也更多。总体而言,全科医生与患者之间的相互理解被证明是患者依从性的有力预测指标。这些发现对于生活在两个世界中的患者尤其适用,即传统与西方文化的混合体。研究结果将从方法学问题以及对医疗保健提供者的实际影响方面进行讨论。

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