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基层医疗中应对和处理文化差异:一项质性访谈研究。

Meeting and treating cultural difference in primary care: a qualitative interview study.

作者信息

Wachtler Caroline, Brorsson Annika, Troein Margareta

机构信息

Institution for Clinical Sciences, Malmö, Department of Primary Care, Lund University, Sweden, Malmö University Hospital, SE 20502 Malmö, Sweden.

出版信息

Fam Pract. 2006 Feb;23(1):111-5. doi: 10.1093/fampra/cmi086. Epub 2005 Oct 24.

Abstract

BACKGROUND

Primary care doctors see patients from diverse cultural backgrounds and communication plays an important role in diagnosis and treatment. Communication problems can arise when patient and doctor do not share the same cultural background.

OBJECTIVE

The aim of this study was to examine how consultations with immigrant patients are understood by GPs and how GPs manage these consultations.

METHODS

Semi-structured interviews with GPs about their experiences with immigrant patients were recorded on audio-tape, transcribed and analysed using a qualitative thematic analysis methodology. A constructivist approach was taken to analysis and interpretation.

RESULTS

Culture is not in focus when GPs meet immigrant patients. The consultation is seen as a meeting between individuals, where cultural difference is just one of many individual factors that influence how well doctor and patient understand each other. However, when mutual understanding is poor and the consultation not successful, cultural differences are central. The GPs try to conduct their consultations with immigrant patients in the same way that they conduct all their consultations. There is no specific focus on culture, instead, GPs tend to avoid addressing even pronounced cultural differences.

CONCLUSION

This study indicates that cultural difference is not treated in GPs consultation with immigrant patients. Learning about cultural difference's effect on mutual understanding between doctor and patient could improve GPs cross-cultural communication. Increased awareness of the culture the doctor brings to the consultation could facilitate management of cross-cultural consultations.

摘要

背景

基层医疗医生会接待来自不同文化背景的患者,沟通在诊断和治疗中起着重要作用。当患者和医生没有相同的文化背景时,可能会出现沟通问题。

目的

本研究的目的是考察全科医生如何理解与移民患者的诊疗过程,以及他们如何管理这些诊疗。

方法

对全科医生进行半结构化访谈,了解他们与移民患者的经历,访谈内容录音、转录,并采用定性主题分析方法进行分析。采用建构主义方法进行分析和解释。

结果

全科医生接诊移民患者时,文化并非重点。诊疗被视为个体之间的会面,文化差异只是影响医患相互理解程度的众多个体因素之一。然而,当相互理解不佳且诊疗不成功时,文化差异就成为核心问题。全科医生试图以他们进行所有诊疗的相同方式来对待与移民患者的诊疗。没有对文化进行特别关注,相反,全科医生甚至倾向于避免提及明显的文化差异。

结论

本研究表明,全科医生在与移民患者的诊疗中并未处理文化差异问题。了解文化差异对医患相互理解的影响可能会改善全科医生的跨文化沟通。提高对医生自身带入诊疗过程的文化的认识,可能有助于跨文化诊疗的管理。

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