Department of Internal Medicine, Hôpital du Jura, Delémont, Switzerland.
Trop Med Int Health. 2010 Sep;15(9):1099-108. doi: 10.1111/j.1365-3156.2010.02575.x. Epub 2010 Jun 9.
To compare traditional healers (TH) and Cameroonian representatives of Western medicine (Western providers (WP)) in terms of patient characteristics and communication patterns during the consultation in rural Cameroon.
A facility-based comparative study was conducted. Seven TH were compared to eight WP in the same district. Patients (five per provider) provided detailed socio-demographic data. Recorded consultations were analysed with the Roter Interaction Analysis System (RIAS).
Patients were similar in socio-demographic characteristics except for age, where TH patients were on average 9 years younger (P < 0.05). Patients of TH travelled 2.5 times as far to their provider as did patients in the WP group (79 vs. 31 km; P < 0.05) and paid 12 times more for their treatment (123 vs. 10 Euros; P < 0.05). Consultations of TH were shorter (5.6 vs. 10.3 min, P < 0.01), had fewer utterances (100 vs. 166, P < 0.05) and the patient's share in the communication was smaller (P < 0.01). TH had a higher percentage of lifestyle and psychosocial information at the expense of medical information (P < 0.05) and communicated more emotionally (P < 0.001). They asked more frequently for their patients' opinion (P < 0.01) and explicitly discussed their patients' concept of illness (P < 0.001). Patients of TH responded with a higher percentage of active communication (P < 0.05) i.e. question asking (P < 0.01).
Our data contradict the idea that the lack of money or geographical access to Western health care in rural Africa is the main reason for people to consult traditional healers. Compared to WP, TH interacted very differently with their clients, using a more patient-centred communication style, to seek common ground with patients. This different type of interaction could be a relevant factor contributing to the popularity of traditional healers in Cameroon.
在喀麦隆农村地区，比较传统治疗师（TH）和喀麦隆西医代表（WP）在患者特征和咨询期间的沟通模式方面的差异。
进行了一项基于医疗机构的比较研究。在同一地区，将 7 名 TH 与 8 名 WP 进行了比较。每位提供者的患者（5 名）提供详细的社会人口统计学数据。使用 Roter 互动分析系统（RIAS）对记录的咨询进行分析。
患者在社会人口统计学特征方面相似，除了年龄，TH 患者平均年轻 9 岁（P < 0.05）。TH 患者前往其提供者的距离是 WP 组患者的 2.5 倍（79 与 31 公里；P < 0.05），并且治疗费用高出 12 倍（123 与 10 欧元；P < 0.05）。TH 的咨询时间更短（5.6 与 10.3 分钟，P < 0.01），言语更少（100 与 166，P < 0.05），患者在沟通中的参与度更小（P < 0.01）。TH 更倾向于提供生活方式和心理社会信息，而不是医疗信息（P < 0.05），并且表现出更多的情感交流（P < 0.001）。他们更频繁地征求患者的意见（P < 0.01），并明确讨论患者对疾病的看法（P < 0.001）。TH 的患者以更高的比例做出积极的回应（P < 0.05），即提问（P < 0.01）。
我们的数据与以下观点相矛盾，即在非洲农村地区，由于缺乏资金或无法获得西医治疗，人们才会选择咨询传统治疗师。与 WP 相比，TH 与患者的互动方式非常不同，他们采用了更以患者为中心的沟通方式，与患者建立共识。这种不同类型的互动可能是传统治疗师在喀麦隆受欢迎的一个相关因素。
