Lin Ivan, Green Charmaine, Bessarab Dawn
Western Australian Centre for Rural Health, The University of Western Australia, PO Box 109, Geraldton, WA 6531, Australia.
Centre for Aboriginal Medical and Dental Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
Aust J Prim Health. 2016 Nov;22(5):377-382. doi: 10.1071/PY16051.
Although successful communication is at the heart of the clinical consultation, communication between Aboriginal patients and practitioners such as doctors, nurses and allied health professionals, continues to be problematic and is arguably the biggest barrier to the delivery of successful health care to Aboriginal people. This paper presents an overarching framework for practitioners to help them reorientate their communication with Aboriginal patients using 'clinical yarning'. Clinical yarning is a patient-centred approach that marries Aboriginal cultural communication preferences with biomedical understandings of health and disease. Clinical yarning consists of three interrelated areas: the social yarn, in which the practitioner aims to find common ground and develop the interpersonal relationship; the diagnostic yarn, in which the practitioner facilitates the patient's health story while interpreting it through a biomedical or scientific lens; and the management yarn, that employs stories and metaphors as tools for patients to help them understand a health issue so a collaborative management approach can be adopted. There is cultural and research evidence that supports this approach. Clinical yarning has the potential to improve outcomes for patients and practitioners.
尽管有效的沟通是临床会诊的核心,但原住民患者与医生、护士及其他健康专业人员等从业者之间的沟通仍然存在问题,可以说这是为原住民提供成功医疗服务的最大障碍。本文为从业者提供了一个总体框架,以帮助他们运用“临床聊天”重新调整与原住民患者的沟通方式。临床聊天是一种以患者为中心的方法,它将原住民文化沟通偏好与对健康和疾病的生物医学理解相结合。临床聊天包括三个相互关联的方面:社交聊天,从业者旨在在此过程中找到共同点并发展人际关系;诊断聊天,从业者在通过生物医学或科学视角解读患者健康故事的同时,促进患者讲述该故事;管理聊天,即运用故事和隐喻作为工具,帮助患者理解健康问题,从而能够采用协作式管理方法。有文化和研究证据支持这种方法。临床聊天有潜力改善患者和从业者的治疗效果。