Shore Jay H, Savin Daniel M, Novins Douglas, Manson Spero M
American Indian and Alaska Native Programs, University of Colorado at Denver and Health Sciences Center, 80045, USA.
J Telemed Telecare. 2006;12(3):116-21. doi: 10.1258/135763306776738602.
Telepsychiatry may involve working with clinicians, patients and systems of care that are both geographically and culturally distinct. In this context, culturally appropriate care is an important component of telepsychiatry. The outline for cultural formulation from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides general principles for addressing these issues. Two components of the outline are particularly relevant in telepsychiatry: (1) how the cultural background of patients (i.e. their cultural identity) influences their comfort with technology; and (2) the effect of cultural differences on the patient-provider relationship. Cultural differences between patient and provider are often highlighted in telepsychiatry by the patient and provider location (e.g. rural versus urban differences). Familiarity with the rural community and regular contact and feedback are important. Future research should examine the effect of telepsychiatry on patient-provider relationships, patient attitudes towards care and, most importantly, patient outcomes.
远程精神病学可能涉及与地理位置和文化背景都不同的临床医生、患者及护理系统合作。在这种情况下，文化上适宜的护理是远程精神病学的一个重要组成部分。《精神疾病诊断与统计手册》（DSM - IV）中的文化定式大纲提供了处理这些问题的一般原则。该大纲的两个组成部分在远程精神病学中尤为相关：（1）患者的文化背景（即他们的文化身份）如何影响他们对技术的接受程度；（2）文化差异对医患关系的影响。患者和提供者之间的文化差异在远程精神病学中常常因患者和提供者的位置而凸显出来（例如农村与城市的差异）。熟悉农村社区以及定期的联系和反馈很重要。未来的研究应该考察远程精神病学对医患关系、患者对护理的态度，以及最重要的，患者的治疗效果的影响。
