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文化谦逊与联络会诊精神病学实践。

Cultural Humility and the Practice of Consultation-Liaison Psychiatry.

机构信息

Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA; Psychiatry, Harvard Medical School, Boston, MA.

Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA.

出版信息

Psychosomatics. 2020 Jul-Aug;61(4):313-320. doi: 10.1016/j.psym.2020.03.002. Epub 2020 Mar 10.

Abstract

BACKGROUND

Cultural competency has long been the gold standard for clinicians who treat patients of different races and/or cultural backgrounds than their own. However, in recent years, there has been increasing criticism of the cultural competency framework because of its reliance on stereotypes and an overemphasis on knowledge acquisition.

OBJECTIVE

We review this transition, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility, including how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management.

METHODS

We review the transition from cultural competency to cultural humility, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility.

RESULTS

We illustrate how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management.

CONCLUSIONS

Cultural humility, which minimizes the power imbalance between clinicians and patients and emphasizes patient-focused interviewing and care, is a useful approach for consultation-liaison psychiatrists working with diverse patients and with diverse multidisciplinary teams in the general hospital.

摘要

背景

文化能力一直是治疗与自身种族和/或文化背景不同的患者的临床医生的黄金标准。然而,近年来,由于其对刻板印象的依赖和对知识获取的过分强调,文化能力框架受到了越来越多的批评。

目的

我们回顾了这一转变,包括对文化能力的批评。我们强调了精神科医生多样性、文化谦逊教育和培训方面的趋势,包括联络精神病医生如何将《精神障碍诊断与统计手册》第五版中关于文化在临床诊断、治疗和管理中的作用的新进展纳入其中。

方法

我们回顾了从文化能力到文化谦逊的转变,包括对文化能力的批评。我们强调了精神科医生多样性、文化谦逊教育和培训方面的趋势。

结果

我们说明了联络精神病医生如何将《精神障碍诊断与统计手册》第五版中关于文化在临床诊断、治疗和管理中的作用的新进展纳入其中。

结论

文化谦逊最大限度地减少了临床医生和患者之间的权力不平衡,并强调以患者为中心的访谈和护理,对于与不同患者以及综合医院的多元化多学科团队合作的联络精神病医生来说,是一种有用的方法。

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