Department of Research, American Academy of Pediatrics, Elk Grove Village, IL, USA.
Acad Pediatr. 2013 Jan-Feb;13(1):65-71. doi: 10.1016/j.acap.2012.10.005.
To describe the diversity of pediatric residents and examine relationships of cross-cultural training experiences with training satisfaction, perceived preparedness for providing culturally effective care, and attitudes surrounding care for underserved populations.
A cross-sectional survey was conducted of a national random sample of graduating pediatric residents and an additional sample of minority residents. Using weighted analysis, we used multivariate regression to test for differences in satisfaction, preparedness, and attitudes between residents with more and less cross-cultural experiences during residency, controlling for residents' characteristics and experiences before training.
The survey response rate was 57%. Eleven percent were Hispanic, 61% white, 21% Asian, 9% African American, 9% other racial/ethnic groups; 34% grew up in a bi- or multilingual family. Ninety-three percent of residents were satisfied with their residency training, 81% with the instruction they received on health and health care disparities, and 54% on global health issues. Ninety-six percent of residents felt they were prepared to care for patients from diverse backgrounds, but fewer felt prepared to care for families with beliefs at odds with Western medicine (49%) and families who receive alternative or complementary care (37%). Residents with more cross-cultural experiences during residency reported being better prepared than those with less experience to care for families with limited English proficiency (adjusted odds ratio [aOR] 2.11; 95% confidence interval [CI] 1.40-3.17), new immigrants (aOR 1.91; 95% CI 1.32-2.75), and with religious beliefs that might affect clinical care (aOR 1.62; 95% CI 1.13-2.32).
Pediatric residents begin their training with diverse cross-cultural backgrounds and experiences. Residency experiences in cross-cultural care contribute to feelings of preparedness to care for diverse US children.
描述儿科住院医师的多样性，并研究跨文化培训经历与培训满意度、提供文化上有效的医疗服务的准备程度以及对为服务不足人群提供医疗服务的态度之间的关系。
对全国范围内即将毕业的儿科住院医师和少数族裔住院医师进行了一项横断面调查。使用加权分析，我们使用多元回归检验了在住院期间经历更多和更少跨文化体验的住院医师在满意度、准备程度和态度方面的差异，同时控制了住院医师在培训前的特征和经历。
调查的回复率为 57%。11%的受访者是西班牙裔，61%是白人，21%是亚裔，9%是非裔美国人，9%是其他种族/族裔群体；34%的人在双语或多语家庭中长大。93%的住院医师对他们的住院医师培训感到满意，81%对他们接受的关于健康和医疗保健差距的指导感到满意，54%对全球卫生问题感到满意。96%的住院医师认为他们有能力为来自不同背景的患者提供医疗服务，但认为自己能够为信仰与西医不一致的家庭（49%）和接受替代或补充医疗服务的家庭（37%）提供医疗服务的人数较少。与在住院期间经历较少跨文化体验的住院医师相比，经历更多跨文化体验的住院医师报告说，他们更有准备为英语水平有限的家庭（调整后的优势比 [aOR] 2.11；95%置信区间 [CI] 1.40-3.17）、新移民（aOR 1.91；95% CI 1.32-2.75）和可能影响临床护理的宗教信仰的家庭提供医疗服务（aOR 1.62；95% CI 1.13-2.32）。
儿科住院医师在开始培训时具有多样化的跨文化背景和经历。跨文化护理方面的住院医师经历有助于他们为美国多样化的儿童提供医疗服务做好准备。
