Southern Lapland Research Department, Vilhelmina, Sweden.
Scand J Public Health. 2012 Aug;40(6):516-22. doi: 10.1177/1403494812453971. Epub 2012 Aug 7.
To investigate the confidence in primary health care, psychiatry and social services among the reindeer-herding Sami and the non-Sami population of northern Sweden.
A semi-randomized, cross-sectional study design comprising 325 reindeer-herding Sami (171 men, 154 women) and a control population of 1,437 non-Sami (684 men, 753 women). A questionnaire on the confidence in primary health care, psychiatry, social services, and work colleagues was distributed to members of reindeer-herding families through the Sami communities and to the control population through the post. The relative risk for poor confidence was analyzed by calculating odds ratios with 95% confidence intervals adjusted for age and level of education.
The confidence in primary health care and psychiatry was significantly lower among the reindeer-herding Sami compared with the control group. No differences were found between men and women in the reindeer-herding Sami population. In both the reindeer-herding Sami and the control population, younger people (≤ 48 years) reported significantly lower confidence in primary health care than older individuals (>48 years).
A conceivable reason for the poor confidence in health care organizations reported by the reindeer-herding Sami is that they experience health care staff as poorly informed about reindeer husbandry and Sami culture, resulting in unsuitable or unrealistic treatment suggestions. The findings suggest that the poor confidence constitutes a significant obstacle of the reindeer-herding Sami to fully benefit from public health care services.
调查瑞典北部驯鹿牧民和非驯鹿牧民的初级保健、精神病学和社会服务信心。
一项半随机、横断面研究设计,包括 325 名驯鹿牧民(171 名男性,154 名女性)和 1437 名非驯鹿牧民(684 名男性,753 名女性)的对照组。通过萨米社区向驯鹿牧民家庭的成员和对照组通过邮寄方式分发了一份关于初级保健、精神病学、社会服务和同事信心的问卷。通过计算调整年龄和教育水平后的 95%置信区间的优势比,分析信心差的相对风险。
与对照组相比,驯鹿牧民对初级保健和精神病学的信心明显较低。在驯鹿牧民群体中,男女之间没有差异。在驯鹿牧民和对照组中,年轻人(≤48 岁)对初级保健的信心明显低于老年人(>48 岁)。
驯鹿牧民对医疗保健组织信心较差的一个可能原因是他们认为医疗保健人员对驯鹿养殖和萨米文化了解不足,导致治疗建议不适当或不切实际。研究结果表明,信心不足是驯鹿牧民充分受益于公共卫生保健服务的一个重大障碍。