Jarvis G Eric, Kirmayer Laurence J, Gómez-Carrillo Ana, Aggarwal Neil Krishan, Lewis-Fernández Roberto
Division of Social and Transcultural Psychiatry, McGill University, and Culture and Mental Health Research Unit, Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec (Jarvis, Kirmayer, Gómez-Carrillo); Department of Psychiatry, Columbia University, New York (Aggarwal, Lewis-Fernández); New York State Center of Excellence for Cultural Competence (Aggarwal, Lewis-Fernández), Anxiety Disorders Clinic (Lewis-Fernández), and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York.
Focus (Am Psychiatr Publ). 2020 Jan;18(1):40-46. doi: 10.1176/appi.focus.20190037. Epub 2020 Jan 24.
This article reviews the clinical and research literature on the Cultural Formulation Interview (CFI) since its publication in . The CFI is an interview protocol designed to be used by clinicians in any setting to gather essential data to produce a cultural formulation. The CFI aims to improve culturally sensitive diagnosis and treatment by focusing clinical attention on the patient's perspective and social context. Preliminary evidence indicates that the CFI can improve clinical communication by enhancing clinician-patient rapport, allowing the clinician to obtain new, cultural data in a relatively short period, eliciting patients' perspectives on what caused their symptoms, and helping patients to become aware of their problems in more insightful ways. With practice, the CFI takes approximately 20 minutes to complete. The CFI has been evaluated internationally in the United States, Canada, Kenya, Peru, the Netherlands, India, and Mexico and generally has been found to be clinically acceptable and useful in these varied settings. Clinicians receiving as little as one hour of training on the CFI improved their ability to work with culturally diverse patients. The CFI may be more difficult to conduct with patients who have severe symptoms, including acute psychosis, suicidal behavior, aggression, and cognitive impairment. The CFI provides a simple way to begin the process of cultural assessment, and its systematic use can foster a reflective stance and promote systemic thinking in routine clinical practice about the patient's life and experience.
本文回顾了自《文化定式访谈（CFI）》发表以来的临床和研究文献。CFI是一种访谈方案，旨在供临床医生在任何环境中使用，以收集基本数据，从而形成文化定式。CFI旨在通过将临床注意力集中于患者的观点和社会背景，改善具有文化敏感性的诊断和治疗。初步证据表明，CFI可以通过增强医患关系来改善临床沟通，使临床医生能够在相对较短的时间内获取新的文化数据，引出患者对其症状成因的看法，并帮助患者以更具洞察力的方式认识自己的问题。经过练习，完成CFI大约需要20分钟。CFI已在美国、加拿大、肯尼亚、秘鲁、荷兰、印度和墨西哥等国家进行了国际评估，总体上发现在这些不同的环境中，它在临床上是可接受且有用的。接受过仅一小时CFI培训的临床医生，其与具有文化多样性患者合作的能力得到了提高。对于有严重症状的患者，包括急性精神病、自杀行为、攻击行为和认知障碍患者，进行CFI可能会更困难。CFI提供了一种开始文化评估过程的简单方法，其系统使用可以培养一种反思态度，并在常规临床实践中促进对患者生活和经历的系统性思考。
