Diette Gregory B, Rand Cynthia
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 5th Floor, 1830 E Monument St, Baltimore, MD 21205, USA.
Chest. 2007 Nov;132(5 Suppl):802S-809S. doi: 10.1378/chest.07-1909.
Asthma is a common, chronic illness with substantial morbidity, especially for racial and ethnic minorities in the United States. The care of the patient with asthma is complex and depends ideally on excellent communication between patients and health-care providers. Communication is essential for the patient to communicate the severity of his or her illness, as well as for the health-care provider to instruct patients on pharmacologic and nonpharmacologic care. This article describes evidence for poor provider/patient communication as a contributor to health-care disparities for minority patients with asthma. Communication problems stem from issues with patients, health-care providers, and health-care systems. It is likely that asthma disparities can be improved, in part, by improving patient/provider communication. While much is known presently about the problem of patient/provider communication in asthma, there is a need to improve and extend the evidence base on the role of effective communication of asthma care and the links to outcomes for minorities. Additional studies are needed that document the extent to which problems with doctor/patient communication lead to inadequate care and poor outcomes for minorities with asthma, as well as mechanisms by which these disparities occur.
哮喘是一种常见的慢性疾病,发病率很高,在美国的种族和少数民族中尤为如此。哮喘患者的护理很复杂,理想情况下取决于患者与医疗服务提供者之间的良好沟通。沟通对于患者传达其疾病的严重程度至关重要,对于医疗服务提供者指导患者进行药物和非药物护理也至关重要。本文描述了医疗服务提供者与患者之间沟通不畅是导致哮喘少数族裔患者医疗保健差异的一个因素的证据。沟通问题源于患者、医疗服务提供者和医疗保健系统等方面的问题。通过改善患者与医疗服务提供者之间的沟通,哮喘差异问题有可能在一定程度上得到改善。虽然目前对哮喘患者与医疗服务提供者之间沟通问题已有很多了解,但仍需要改进并扩大关于哮喘护理有效沟通的作用以及与少数族裔患者结局之间联系的证据基础。还需要进行更多研究,以记录医患沟通问题导致哮喘少数族裔患者护理不足和不良结局的程度,以及这些差异产生的机制。