Renzaho Andre
School of Health and Social Development, Deakin University, Burwood, VIC, Australia.
Aust Health Rev. 2008 May;32(2):223-35. doi: 10.1071/ah080223.
There are few studies exploring the need to develop and manage culturally competent health services for refugees and migrants from diverse backgrounds. Using data from 50 interviews with service providers from 26 agencies, and focus group discussion with nine different ethnic groups, this paper examines how the Victorian state government funding and service agreements negatively impact on the quest to achieve cultural competence. The study found that service providers have adopted "one approach fits all" models of service delivery. The pressure and competition for resources to address culturally and linguistically diverse communities' needs allows little opportunity for partnership and collaboration between providers, leading to insufficient sharing of information and duplication of services, poor referrals, incomplete assessment of needs, poor compliance with medical treatment, underutilisation of available services and poor continuity of care. This paper outlines a model for cultural consultation and developing needs-led rather than service-led programs.
很少有研究探讨为来自不同背景的难民和移民开发和管理具有文化能力的医疗服务的必要性。本文利用对来自26个机构的服务提供者进行的50次访谈数据，以及与9个不同种族群体进行的焦点小组讨论，研究了维多利亚州政府的资金和服务协议如何对实现文化能力的追求产生负面影响。研究发现，服务提供者采用了“一刀切”的服务模式。为满足文化和语言多样化社区需求而进行资源竞争的压力，使得提供者之间几乎没有合作与协作的机会，导致信息共享不足、服务重复、转诊不佳、需求评估不完整、医疗治疗依从性差、可用服务利用不足以及护理连续性差。本文概述了一个文化咨询模型，并提出了开发以需求而非服务为导向的项目的建议。
