Shirazi Mandana, Ponzer Sari, Zarghi Nazila, Keshmiri Fatemeh, Karbasi Motlagh Maryam, Khorasani Zavareh Davoud, Khankeh Hamid R
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Educational Development Center of Tehran University of Medical Sciences, Medical Education Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Int J Med Educ. 2020 Aug 20;11:158-168. doi: 10.5116/ijme.5f19.5749.
This study aimed to explore Swedish physicians' perceptions regarding physician-patient communication in an Iranian context and to obtain a deeper understanding of their lived experience when encountering Middle Eastern and Swedish patients in their daily work.
This is a multi-method study, including conventional content analysis in combination with phenomenological methodology. A triangulation approach to data collection and analysis was used. Serving the purpose of the study, twelve Swedish physicians with previous experience of Middle Eastern patients were purposely selected to participate in the study. They watched a video showing simulated patient encounter in an Iranian context. The video served as a trigger. Semi-structured interviews were conducted focusing on the participants' perceptions of the video and their lived experiences. Constant comparative analysis was used for a deep understanding of the data.
The core themes were cultural diversity, doctor-centeredness, and patient-centeredness. Cultural diversity was a convergent theme and included trust, interpersonal interaction, context, and doctor dominancy. Patient-centeredness and doctor-centeredness were divergent themes and included doctors' authority, equity, the experience of illness, and accountability.
The participants confirmed large cultural differences in doctor-patient communication when encountering Iranian and Swedish patients. Inter-cultural and cross-cultural competencies were made visible. To be able to appreciate other cultures' health values, beliefs, and behaviors, increased cultural competence in health care is of importance.
本研究旨在探讨瑞典医生对伊朗背景下医患沟通的看法,并更深入地了解他们在日常工作中接触中东和瑞典患者时的生活经历。
这是一项多方法研究,包括传统内容分析与现象学方法相结合。采用了数据收集和分析的三角测量法。为了达到研究目的,特意挑选了12名有中东患者诊疗经验的瑞典医生参与研究。他们观看了一段展示伊朗背景下模拟医患会面的视频。该视频作为触发点。进行了半结构化访谈,重点关注参与者对视频的看法及其生活经历。采用持续比较分析以深入理解数据。
核心主题为文化多样性、以医生为中心和以患者为中心。文化多样性是一个趋同主题,包括信任、人际互动、背景和医生主导地位。以患者为中心和以医生为中心是不同主题,包括医生的权威、公平、患病体验和责任。
参与者证实,在接触伊朗和瑞典患者时,医患沟通存在很大的文化差异。跨文化和交叉文化能力得以显现。为了能够理解其他文化的健康价值观、信仰和行为,提高医疗保健中的文化能力很重要。