Palinkas L A, Pickwell S M
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0807, USA.
Soc Sci Med. 1995 Jun;40(12):1643-53. doi: 10.1016/0277-9536(94)00344-s.
Although the concept of acculturation originated within anthropology, in recent years it has assumed a prominent role within epidemiology as a risk factor for chronic disease. However, these studies often consider acculturation in structural terms, reflected in differences between groups assumed to lie along the same continuum, all moving in the same direction toward greater acculturation to the values and behaviors of the dominant society. This paper addresses how acculturation should be conceptualized when examining it as a potential risk factor for chronic disease and how it should be measured so that it becomes both theoretically and clinically meaningful. Four case studies of Cambodian refugees of San Diego, California are used to illustrate the following: (1) the importance of integrating an acculturation-as-process perspective with an acculturation-as-structure perspective; (2) viewing acculturation as both individual and group experience of conflict and negotiation between two systems of behavior and belief; (3) measuring it longitudinally and as narrative; and (4) understanding that rather than being an inherent health risk, it may also promote health by creating access to certain forms of health care unavailable in the country of origin and by contributing to the abandonment of risky health-related behaviors and the adoption of behaviors that promote good health.
尽管文化适应的概念起源于人类学领域，但近年来它在流行病学中作为慢性病的一个风险因素已占据显著地位。然而，这些研究往往从结构角度看待文化适应，这体现在假定处于同一连续体上的群体之间的差异，所有群体都朝着更大程度地适应主流社会的价值观和行为这一相同方向发展。本文探讨了在将文化适应视为慢性病的潜在风险因素进行研究时，应如何对其进行概念化，以及应如何进行测量，以便使其在理论和临床层面都具有意义。通过对加利福尼亚州圣地亚哥的柬埔寨难民进行的四个案例研究来说明以下几点：（1）将文化适应作为过程的视角与文化适应作为结构的视角相结合的重要性；（2）将文化适应视为两种行为和信仰体系之间冲突与协商的个人和群体体验；（3）纵向且以叙事方式对其进行测量；（4）认识到文化适应并非固有健康风险，它还可能通过创造获得原籍国无法提供的某些形式的医疗保健的机会，以及促使放弃有风险的健康相关行为并采用促进健康的行为来促进健康。
