a Department of Sociology , University of California Los Angeles.
b School of Social and Community Medicine , University of Bristol.
Health Commun. 2018 Nov;33(11):1377-1388. doi: 10.1080/10410236.2017.1350917. Epub 2017 Sep 5.
This study investigates patient resistance to doctors' treatment recommendations in a cross-national comparison of primary care. Through this lens, we explore English and American patients' enacted priorities, expectations, and assumptions about treating routine illnesses with prescription versus over-the-counter medications. We perform a detailed analysis of 304 (American) and 393 (English) naturally occurring treatment discussions and conclude that American and English patients tend to use treatment resistance in different prescribing contexts to pursue different ends. While American patients are most likely to resist recommendations for non-prescription treatment and display an expectation for prescription treatment in these interactions, English patients show a high level of resistance to recommendations for all types of treatment and display an expectation of cautious prescribing. These behavioral trends reflect broader structural forces unique to each national context and ultimately maintain distinct cultural norms of good-practice prescribing.
本研究通过对初级保健的跨国比较，调查了患者对医生治疗建议的抵制。通过这一视角，我们探讨了英、美两国患者在对待常规疾病的处方药物和非处方药物治疗时，所表现出的优先事项、期望和假设。我们对 304 例（美国）和 393 例（英国）自然发生的治疗讨论进行了详细分析，得出结论：美英两国患者在不同的处方环境中使用治疗抵制来追求不同的目的。虽然美国患者在这些互动中最有可能抵制非处方治疗的建议，并期望得到处方治疗，但英国患者对所有类型的治疗建议都表现出高度的抵制，并期望谨慎处方。这些行为趋势反映了每个国家背景所特有的更广泛的结构性力量，并最终维持了良好实践处方的独特文化规范。
