Shahid Shaouli, Finn Lizzie D, Thompson Sandra C
Centre for International Health, Curtin University of Technology, Perth, WA, Australia.
Med J Aust. 2009 May 18;190(10):574-9. doi: 10.5694/j.1326-5377.2009.tb02569.x.
To report Aboriginal patients' views about effective communication between Aboriginal people and health service providers in Western Australian hospital settings.
DESIGN, SETTING AND PARTICIPANTS: Qualitative study involving indepth interviews between 1 March 2006 and 30 September 2007 with 30 Aboriginal people affected by cancer from across WA.
Aboriginal patients' views about the quality of communication within the hospitals, factors impairing communication and suggestions for improvement.
Factors crucial to effective patient-provider communication such as language, shared understanding, knowledge and use of medical terminology require attention. Additionally, communication between Aboriginal people and health care professionals needs to be understood within a broader sociocultural and political context. Fear of the medical system and of being disempowered; mistrust; collective memories of the experience of colonisation and its aftermath; lack of understanding of Aboriginal customs, values, lifestyle and the importance of family and land; and experiences of racism were key issues impairing communication. Health service providers' inability to interpret non-verbal communication and the symbolism of hospital environments also posed problems.
Key areas for the attention of health service providers in communicating and caring for Aboriginal people in the hospital setting include culturally sensitive and empathetic personal contact, acknowledgement and respect for Aboriginal family structures, culture and life circumstances, an understanding of the significant role of non-verbal communication, and the importance of history, land and community. Employing more Aboriginal health workers in hospitals, and allowing Aboriginal people to participate at a decision-making level in hospitals is likely to improve Aboriginal people's access to cancer treatment, and would be important symbols of progress in this area.
报告澳大利亚原住民患者对于西澳大利亚医院环境中原住民与医疗服务提供者之间有效沟通的看法。
设计、地点和参与者：定性研究，于2006年3月1日至2007年9月30日期间对来自西澳大利亚各地的30名受癌症影响的原住民进行了深入访谈。
原住民患者对医院内沟通质量的看法、影响沟通的因素以及改进建议。
对于有效的医患沟通至关重要的因素，如语言、共同理解、医学术语的知识和使用等都需要关注。此外，原住民与医疗保健专业人员之间的沟通需要在更广泛的社会文化和政治背景下加以理解。对医疗系统的恐惧和感到无力；不信任；对殖民经历及其后果的集体记忆；对原住民习俗、价值观、生活方式以及家庭和土地重要性的缺乏理解；以及种族主义经历是影响沟通的关键问题。医疗服务提供者无法解读非语言沟通以及医院环境的象征意义也带来了问题。
在医院环境中，医疗服务提供者在与原住民沟通和护理时需要关注的关键领域包括具有文化敏感性和同理心的个人接触、对原住民家庭结构、文化和生活环境予以认可和尊重、理解非语言沟通的重要作用以及历史、土地和社区的重要性。在医院雇佣更多的原住民医护人员，并让原住民在医院决策层面参与，可能会改善原住民获得癌症治疗的机会，并且将是这一领域进步的重要标志。
