Betancourt Joseph R
The Disparities Solutions Center, Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Acad Med. 2006 Jun;81(6):499-501. doi: 10.1097/01.ACM.0000225211.77088.cb.
Two contemporary reports from the Institute of Medicine--Crossing the Quality Chasm and Unequal Treatment--highlighted the importance of patient-centered care and cultural competence training as a means of improving the quality of health care for all and eliminating racial/ethnic disparities in health care. Previous efforts in cultural competence have aimed to teach about the attitudes, values, beliefs, and behavior of certain groups. A more effective approach is to learn a practical framework to guide inquiry with individual patients about how social, cultural, or economic factors influence their health values, beliefs, and behaviors. Rather than learning about individual cultures and their characteristics, this approach focuses on the issues that arise most commonly due to cultural differences, and how they may affect a physician's interaction with any patient. At the end of the day, physicians need a practical set of tools and skills that will enable them to provide quality care to patients everywhere, from anywhere, with whatever differences in background that may exist, in what is likely to be a brief clinical encounter. Call it what you will, the field of cultural competence aims quite simply to assure that health care providers are prepared to provide quality care to diverse populations.
医学研究所的两份当代报告——《跨越质量鸿沟》和《不平等待遇》——强调了以患者为中心的护理和文化能力培训的重要性,将其作为提高全民医疗保健质量和消除医疗保健中种族/民族差异的一种手段。以往在文化能力方面的努力旨在传授特定群体的态度、价值观、信仰和行为。一种更有效的方法是学习一个实用框架,以指导与个体患者探讨社会、文化或经济因素如何影响他们的健康价值观、信仰和行为。这种方法不是学习各个文化及其特征,而是关注因文化差异最常出现的问题,以及这些问题可能如何影响医生与任何患者的互动。归根结底,医生需要一套实用的工具和技能,使他们能够在可能很短暂的临床接触中,无论患者背景存在何种差异,无论身处何地,都能为各地的患者提供高质量的护理。不管你怎么称呼它,文化能力领域的目标很简单,就是确保医疗保健提供者做好准备,为不同人群提供高质量的护理。