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调查加拿大具有移民背景的患者和医生的文化适应取向:对遵循医疗建议的影响。

Investigating acculturation orientations of patients with an immigration background and doctors in Canada: implications for medical advice adherence.

作者信息

Whittal Amanda, Hanke Katja, Lippke Sonia

机构信息

Bremen International School of Social Sciences, Jacobs University Bremen, Campus Ring 1, 28759, Bremen, Germany.

St. Mary's Hospital, McGill University, 3830 Lacombe Avenue, Montreal, QC, H3T 1M5, Canada.

出版信息

Qual Life Res. 2017 May;26(5):1223-1232. doi: 10.1007/s11136-016-1438-8. Epub 2016 Oct 19.

Abstract

BACKGROUND

Increased immigration requires successful interaction of different cultures in various life domains, such as health. This study investigates acculturation orientation (AO) of immigrant patients and doctors native to the country, as a potential factor related to perceived medical advice adherence.

DATA AND METHODS

N = 171 immigrant patients (M = 54.38 years, SD = 17.94, range = 23-96, 74.3 % female) and their N = 12 doctors (M = 38.88 years, SD = 13.42, range = 27-66, 83 % female) from a hospital in Montreal, Canada, participated in a paper-based survey to assess AOs, patients' perceived expectations of their doctor (regarding adopting the new culture or keeping their previous culture), doctors' actual expectations, perceived quality of care and perceived adherence.

RESULTS

AO of patients significantly related to perceived adherence, via a path model involving perceptions of doctors' expectations and perceived quality of care. Integration was positively related to perceived adherence, while Marginalization was negatively related to it. Doctors' AOs were not significant.

CONCLUSION

Patient perceptions seem to be a significant factor to be considered when striving to improve immigrant medical advice adherence.

摘要

背景

移民人数的增加要求不同文化在健康等各个生活领域成功互动。本研究调查移民患者和本国医生的文化适应取向(AO),将其作为与感知到的医嘱依从性相关的一个潜在因素。

数据与方法

来自加拿大蒙特利尔一家医院的171名移民患者(年龄均值M = 54.38岁,标准差SD = 17.94,范围23 - 96岁,74.3%为女性)及其12名医生(年龄均值M = 38.88岁,标准差SD = 13.42,范围27 - 66岁,83%为女性)参与了一项纸质调查,以评估文化适应取向、患者对医生的感知期望(关于接受新文化或保留原有文化)、医生的实际期望、感知到的医疗质量和感知到的依从性。

结果

通过一个涉及医生期望感知和感知医疗质量的路径模型,患者的文化适应取向与感知到的依从性显著相关。整合与感知到的依从性呈正相关,而边缘化与感知到的依从性呈负相关。医生的文化适应取向不显著。

结论

在努力提高移民医嘱依从性时,患者的感知似乎是一个需要考虑的重要因素。

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