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本文引用的文献

1
The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review.医患联盟和沟通对精神卫生保健中治疗依从性的影响：系统评价。
BMC Psychiatry. 2012 Jul 24;12:87. doi: 10.1186/1471-244X-12-87.
2
Communication profiles of psychiatric residents and attending physicians in medication-management appointments: a quantitative pilot study.精神科住院医师和主治医生在药物管理预约中的沟通模式：一项定量试点研究。
Acad Psychiatry. 2012 Mar 1;36(2):96-103. doi: 10.1176/appi.ap.10120030.
3
The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care.临床医生种族内隐态度与医疗就诊沟通和患者人际护理评分的关联。
Am J Public Health. 2012 May;102(5):979-87. doi: 10.2105/AJPH.2011.300558. Epub 2012 Mar 15.
4
Psychiatrist-patient verbal and nonverbal communications during split-treatment appointments.精神科医师与患者在分次治疗预约期间的言语和非言语交流。
Psychiatr Serv. 2011 Nov;62(11):1361-8. doi: 10.1176/ps.62.11.pss6211_1361.
5
The relationship among patient contemplation, early alliance, and continuation in psychotherapy.患者沉思、早期联盟与心理治疗持续之间的关系。
Psychotherapy (Chic). 2006 Summer;43(2):238-43. doi: 10.1037/0033-3204.43.2.238.
6
Racial/ethnic matching of clients and therapists in mental health services: a meta-analytic review of preferences, perceptions, and outcomes.心理健康服务中客户与治疗师的种族/民族匹配：偏好、认知和结果的元分析综述。
J Couns Psychol. 2011 Oct;58(4):537-54. doi: 10.1037/a0025266.
7
Depression treatment preferences of Hispanic individuals: exploring the influence of ethnicity, language, and explanatory models.西班牙裔个体的抑郁治疗偏好：探索种族、语言和解释模型的影响。
J Am Board Fam Med. 2011 Jan-Feb;24(1):39-50. doi: 10.3122/jabfm.2011.01.100118.
8
Therapeutic alliance in pediatric primary care: preliminary evidence for a relationship with physician communication style and mothers' satisfaction.儿科初级保健中的治疗联盟：与医生沟通风格和母亲满意度相关的初步证据。
J Dev Behav Pediatr. 2010 Feb-Mar;31(2):83-91. doi: 10.1097/DBP.0b013e3181cda770.
9
Disparity in depression treatment among racial and ethnic minority populations in the United States.美国种族和少数民族群体在抑郁症治疗方面的差异。
Psychiatr Serv. 2008 Nov;59(11):1264-72. doi: 10.1176/ps.2008.59.11.1264.
10
How missing information in diagnosis can lead to disparities in the clinical encounter.诊断中的信息缺失如何导致临床诊疗中的差异。
J Public Health Manag Pract. 2008 Nov;14 Suppl(Suppl):S26-35. doi: 10.1097/01.PHH.0000338384.82436.0d.

患者-临床医生的民族一致性和心理健康就诊时的沟通。

Patient-clinician ethnic concordance and communication in mental health intake visits.

机构信息

Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, USA; Harvard Medical School, Boston, USA.

出版信息

Patient Educ Couns. 2013 Nov;93(2):188-96. doi: 10.1016/j.pec.2013.07.001. Epub 2013 Jul 27.

DOI:10.1016/j.pec.2013.07.001
PMID:23896127
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3800470/
Abstract

OBJECTIVE

This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment.

METHODS

Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews.

RESULTS

Latino concordant dyad patients were more verbally dominant (p<.05), engaged in more patient-centered communication (p<.05) and scored higher on the (WAI-O) bond scale (all p<.05) than other groups. Latino patients had higher continuance rates than other patients in models that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients.

CONCLUSION

Communication patterns seem to explain the role of ethnic concordance for continuance in care.

PRACTICE IMPLICATIONS

Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care.

摘要

目的

本研究考察了心理健康初诊中，不同种族和民族的医患群体沟通模式的差异，以及这些差异与治疗延续性（定义为按时参加下一次预约）的关系。

方法

本研究采用观察性研究方法，对种族/民族一致和不一致的医患群体的沟通模式进行分析。主要分析包括 93 名患者和 38 名临床医生，他们来自种族/民族一致和不一致的医患群体。沟通使用 Roter 互动分析系统（RIAS）和工作联盟量表观察员（WAI-O）进行编码；治疗延续性通过病历回顾得出。

结果

与其他群体相比，拉丁裔一致群体的患者在语言上更具主导性（p<.05），更倾向于以患者为中心的沟通（p<.05），并且在（WAI-O）纽带量表上得分更高（所有 p<.05）。在调整非沟通变量的模型中，拉丁裔患者的继续治疗率高于其他患者。当调整沟通、整体情绪和治疗过程变量时，差异发生逆转，白人医患群体的继续治疗率高于其他医患群体。

结论

沟通模式似乎可以解释种族一致性对治疗延续性的作用。

实践意义

在跨文化接触中改善跨文化沟通对于留住少数族裔患者接受治疗至关重要。