Internal Medicine Department, Universidad del Cauca, Popayán, Colombia
Social and Family Health Department, Universidad del Cauca, Popayán, Colombia
Rural Remote Health. 2022 May;22(2):6698. doi: 10.22605/RRH6698. Epub 2022 May 11.
To describe and understand the attitudes, cultural knowledge, and therapeutic practices of the Misak people concerning rheumatoid arthritis (RA), inscribed in an emergent culturally sensitive healthcare model along with the indigenous community and health professionals, following a respectful and empathic relational contact approach to the inter-ethnic encounter.
A qualitative study that used ethnographic methods using observation techniques and in-depth interviews was carried out in the Misak community, Colombia, by a multidisciplinary team (rheumatology, physiotherapy, and anthropology). A thematic analysis based around the concept of explanatory models (EMs) was carried out.
Researchers interviewed 20 patients with RA, 12 traditional healers, and 5 health professionals. The following themes were identified: (1) the traditional healers are allowed to practice only if the community recognizes their vocation; (2) two types of EM were observed: Misak community EM related to conception of RA and its treatment, shared by patients and the traditional healers; and biomedical EM. The interaction of the two types is still a healthcare challenge that requires articulating to achieve better clinical outcomes for patients.
The EMs of RA care identified in the Misak community are focused on both the patients and the traditional healers. However, this predominant EM and the biomedical EM of RA care need to be brought closer together to contribute to the construction of a unifying model of a culturally sensitive care.
为了描述和理解米萨克人（Misak）对类风湿关节炎（RA）的态度、文化知识和治疗实践，我们在一个新兴的文化敏感型医疗保健模式中，将土著社区和卫生专业人员纳入其中，同时遵循尊重和共情的跨民族接触方法。
这是一项定性研究，使用了民族志方法，包括观察技术和深入访谈，由一个多学科团队（风湿病学、物理疗法和人类学）在哥伦比亚的米萨克社区进行。我们对围绕解释性模型（EM）概念的主题进行了分析。
研究人员采访了 20 名 RA 患者、12 名传统治疗师和 5 名卫生专业人员。确定了以下主题：（1）只有当社区认可他们的职业时，传统治疗师才被允许行医；（2）观察到两种类型的 EM：米萨克社区 EM 与 RA 的概念及其治疗有关，患者和传统治疗师都认同；以及生物医学 EM。两种类型的相互作用仍然是医疗保健的挑战，需要协调一致，以改善患者的临床结果。
在米萨克社区中确定的 RA 护理解释性模型既关注患者，也关注传统治疗师。然而，这种主要的 EM 和 RA 护理的生物医学 EM 需要更加紧密地结合在一起，以促进具有文化敏感性的统一护理模式的构建。
