Centre for Health and Social Care, Institute of Health Sciences, University of Leeds, Leeds, UK.
Ethn Health. 2010 Aug;15(4):327-42. doi: 10.1080/13557851003624273.
Pakistani Muslims have the poorest overall health profile in Britain, for reasons which at present remain poorly understood. We sought to explore the impact of religious identity and beliefs on self-management of long-term conditions, on patient-professional communication and decision-making and health inequalities within Pakistani Muslim communities.
Ethnographic study involving in-depth interviews and participant observation.
Religious identity plays a central role in many individuals' attempts to make sense of their personal illness narrative. Practitioners and patients are typically unwilling to engage in discussion about religious influences on patient decision-making, reflecting patients' lack of confidence in the appropriateness of raising such issues, and professionals' lack of awareness of their importance. Patients consequently receive little or no support from professionals about decisions involving such influences on self-care. The policy vacuum and lack of patient-professional engagement in this area allows the use of stereotypes of Pakistani Muslims by practitioners to remain unchallenged in most healthcare settings. Social dynamics within these settings reflect those in wider UK society, in which many Pakistani respondents believe they are unwelcome. These factors affect the psychosocial well-being of Pakistani Muslims and on their ability to manage long-term conditions.
Shared understanding about the context in which patients manage long-term conditions is a precursor to effective lay-professional partnerships. Religious identity influences the health beliefs and practices of many British Pakistani Muslim patients. Failure to acknowledge and discuss this influence on long-term illness management leads to a vacuum in professional knowledge, inadequate support for patients' decision-making and poor responses to their requests for assistance. Findings indicate a need for practitioners to initiate more open discussion and raise questions about the pathways leading to higher rates of complications and the relationship between social status and health inequalities in this population.
在英国，巴基斯坦穆斯林的整体健康状况最差，其原因目前仍知之甚少。我们试图探讨宗教身份和信仰对长期疾病自我管理、医患沟通和决策以及巴基斯坦穆斯林社区内健康不平等的影响。
参与深入访谈和参与观察的民族志研究。
宗教身份在许多人试图理解个人疾病叙述时起着核心作用。从业者和患者通常不愿意讨论宗教对患者决策的影响，这反映了患者对提出这些问题的适当性缺乏信心，以及专业人员对其重要性缺乏认识。因此，患者在涉及自我护理的此类影响的决策方面几乎得不到专业人员的支持。在这一领域缺乏政策和医患参与，使从业者对巴基斯坦穆斯林的刻板印象得以在大多数医疗保健环境中不受挑战。这些环境中的社会动态反映了英国更广泛社会中的情况，许多巴基斯坦受访者认为他们不受欢迎。这些因素影响了巴基斯坦穆斯林的社会心理福祉及其管理长期疾病的能力。
对患者管理长期疾病的背景有共同的理解是有效医患合作的前提。宗教身份影响许多英国巴基斯坦穆斯林患者的健康信念和实践。如果不承认和讨论这种对长期疾病管理的影响，就会导致专业知识的空白、对患者决策的支持不足以及对他们寻求帮助的反应不佳。研究结果表明，从业者需要更主动地开展讨论，并提出关于导致并发症发生率较高的途径以及该人群中社会地位与健康不平等之间关系的问题。
