Beagan Brenda L, Kumas-Tan Zofia
Dalhousie University, School of Occupational Therapy, 5869 University Ave, Forrest Bldg, Room 215, Halifax, NS B3J 3H5.
Can Fam Physician. 2009 Aug;55(8):e21-8.
To explore family physicians' perceptions of and experiences with patient diversity, including differences in sex, race, ethnicity, social class, sexual orientation, and abilities or disabilities.
Semistructured, in-depth, qualitative interviews. SETTING Halifax metropolitan region, Nova Scotia.
Twenty-two family physicians who ranged in age (25 to 65 years) and in years of practice (< 5 to > 20). Participants included both sexes, members of racialized minority groups, and those who self-identified as gay, lesbian, or bisexual.
Physicians were recruited through information letters distributed by mail and through professional networks. Interviews and field notes were recorded, transcribed verbatim, and coded using data analysis software. Weekly team discussions enhanced interpretation and analysis.
Family physicians employed 5 main approaches to diversity: maintaining that differences do not matter, accommodating sociocultural differences, seeking to better understand differences, seeking to avoid discrimination, and challenging inequities. Quotes from interviews illustrate these themes.
Most approaches assume that both medicine (as a profession) and physicians are and should be socially and culturally neutral; some acknowledge that the sociocultural background of patients can raise tensions. Most participants in our study seek to treat patients as individuals in order to not stereotype, which hinders recognition of the ways in which sociocultural factors-both patients' and physicians'-influence health and health care. Critical reflexivity demands that physicians understand social relations of power and where they fit within those relations.
探讨家庭医生对患者多样性的看法和经历，包括性别、种族、民族、社会阶层、性取向以及身体能力或残疾方面的差异。
半结构化、深入的定性访谈。
新斯科舍省哈利法克斯都会区。
22名家庭医生，年龄在25至65岁之间，执业年限从不足5年到超过20年不等。参与者包括男性和女性、少数族裔成员以及自我认同为同性恋或双性恋的人。
通过邮寄信息信件和专业网络招募医生。对访谈和现场记录进行录音，逐字转录，并使用数据分析软件进行编码。每周的团队讨论加强了解释和分析。
家庭医生采用了5种主要的应对多样性的方法：认为差异无关紧要、适应社会文化差异、寻求更好地理解差异、寻求避免歧视以及挑战不平等。访谈中的引述说明了这些主题。
大多数方法假定医学（作为一种职业）和医生在社会和文化上都是且应该是中立的；一些人承认患者的社会文化背景可能会引发紧张关系。我们研究中的大多数参与者试图将患者作为个体来对待，以免形成刻板印象，这阻碍了对社会文化因素（包括患者和医生的因素）影响健康和医疗保健方式的认识。批判性反思要求医生理解权力的社会关系以及他们在这些关系中的位置。
