Chan-Yip Alice
Department of Paediatrics, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec.
Paediatr Child Health. 2004 Nov;9(9):627-629. doi: 10.1093/pch/9.9.627.
In the past three decades, rapidly changing demographic characteristics have been witnessed in western society. Concurrently, numerous culture-related studies have attested to the disparity in health services among different ethnic groups. Reports have shown contributing factors that can render main stream services inaccessible to immigrants include cultural and language barriers, adaptation difficulties, racial discrimination and lack of culturally appropriate psychosocial services. Inadequate training of health professionals regarding cross-cultural issues may hinder patient compliance and therapeutic alliances. In a paediatric practice in Montreal, prevalent health problems among Chinese families were identified to be related to cultural beliefs and psychosocial factors. These included a low breastfeeding rate (8%) among Chinese newborns, prevalent iron deficiency anemia (12%), nursing caries, social isolation, delayed diagnosis of developmental delay, learning disabilities and psychosocial problems. The participation in community research and advocacy, the development of health promotional projects with an interdisciplinary approach and the preparation of Chinese health information such as perinatal programs, infant nutrition, dental hygiene and immunization, were described. Subsequent studies in this population illustrated an increased breastfeeding rate (48%), decreased incidence of iron deficiency (2.8%) and improved self-health maintenance practices. More culturally appropriate allied health services, including the Multiculturalism Department in the Montreal Children's Hospital, have subsequently been developed for the community.In summary, identifying prevalent health problems of ethnic propensity may be the initiatives needed to develop research and health promotional projects for a target population. Comprehensive health care to different ethnic groups requires health professionals to incorporate cross-cultural issues in their services.
在过去三十年里,西方社会见证了人口特征的迅速变化。与此同时,大量与文化相关的研究证实了不同种族群体在医疗服务方面存在差异。报告显示,导致移民难以获得主流服务的因素包括文化和语言障碍、适应困难、种族歧视以及缺乏符合文化背景的心理社会服务。医护人员在跨文化问题上培训不足可能会妨碍患者的依从性以及治疗联盟。在蒙特利尔的一项儿科实践中,发现华裔家庭中普遍存在的健康问题与文化信仰和心理社会因素有关。这些问题包括华裔新生儿的低母乳喂养率(8%)、普遍存在的缺铁性贫血(12%)、奶瓶龋、社会孤立、发育迟缓、学习障碍和心理社会问题的诊断延迟。文中描述了参与社区研究与宣传、采用跨学科方法开展健康促进项目以及编写中文健康信息,如围产期项目、婴儿营养、口腔卫生和免疫接种等。随后对该人群的研究表明,母乳喂养率有所提高(48%),缺铁发生率有所下降(2.8%),自我健康维护行为也有所改善。随后为该社区开发了更多符合文化背景的联合健康服务,包括蒙特利尔儿童医院的多元文化部门。总之,识别具有种族倾向的普遍健康问题可能是为目标人群开展研究和健康促进项目所需的举措。为不同种族群体提供全面的医疗保健需要医护人员在服务中纳入跨文化问题。