Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia.
Arch Clin Neuropsychol. 2024 Jan 19;39(1):65-77. doi: 10.1093/arclin/acad044.
The field of cultural neuropsychology has grown exponentially over the last three decades. With a limited culturally informed evidence base to guide neuropsychological practice, the acceptability of existing paradigms has been called into question when applied to culturally diverse and educationally disadvantaged groups. This qualitative study aimed to explore the experiences of Greek Australian older adults who underwent a cognitive assessment to better understand potential barriers and facilitators to engagement and to improve neuropsychological assessment outcomes.
Semi-structured interviews were developed to explore cultural attitudes and contextual factors relating to neuropsychological assessment. Interviews were conducted by Greek-speaking neuropsychologists using a sample of 10 healthy elderly Greek Australians following the completion of a comprehensive neuropsychological assessment. Data were analyzed using a phenomenological design within a critical realist framework.
Analysis revealed the emergence of three broad themes: sociocultural factors, experiences within the broader medical system, and the assessment experience. Engagement with cognitive assessment was influenced by several factors, including rapport building, understanding of the assessment, and use of inappropriate tests. Furthermore, level and quality of education, sex differences, language barriers, acculturation, previous experiences of prejudice, anxiety, and a preference for Greek-speaking clinicians were additional factors reported to affect the client experience and validity of assessment outcomes.
Neuropsychological assessment is, in part, affected by culturally reinforced attitudes. Failing to adjust the relationship between the clinician and client, test environment, style of communication, and the use of culturally inappropriate tests is likely to affect the validity of assessment outcomes.
在过去的三十年中，文化神经心理学领域呈指数级增长。由于可供指导神经心理学实践的文化信息有限，当现有的范式应用于文化多样且教育程度较低的群体时，其可接受性受到了质疑。本定性研究旨在探索希腊裔澳大利亚老年人的经历，他们接受了认知评估，以更好地了解参与的潜在障碍和促进因素，并改善神经心理学评估结果。
采用半结构式访谈，探讨与神经心理学评估相关的文化态度和背景因素。由讲希腊语的神经心理学家使用 10 名健康的老年希腊裔澳大利亚人样本进行，在完成全面的神经心理学评估后进行。使用现象学设计在批判现实主义框架内进行数据分析。
分析显示出三个广泛的主题的出现：社会文化因素、更广泛的医疗系统内的经验以及评估经验。认知评估的参与受到多种因素的影响，包括建立融洽关系、理解评估以及使用不适当的测试。此外，教育水平和质量、性别差异、语言障碍、文化同化、以前的偏见经历、焦虑以及对讲希腊语的临床医生的偏好，是据报告影响客户体验和评估结果有效性的其他因素。
神经心理学评估在一定程度上受到文化强化态度的影响。未能调整临床医生与患者之间的关系、测试环境、沟通方式以及使用不适当的文化测试，可能会影响评估结果的有效性。
