Sensky T
Charing Cross & Westminster Medical School, West Middlesex University Hospital, Isleworth.
Br J Cancer Suppl. 1996 Sep;29:S63-5.
Lay beliefs about illness, its causes and its treatment, do not necessarily concur with medical knowledge, and can sometimes be highly idiosyncratic. These beliefs are likely to be influential in help-seeking, in patients' attitudes to professional help, and in the manner in which patients participate is the management of their illness. Clinicians thus need to understand such lay beliefs and attitudes in order to engage their patients in treatment and to provide optimal care. Lay beliefs are likely to be influenced by the individual's culture and hence also by ethnic group. In attempting to understand the patient's beliefs, the researcher or clinician runs the risk of ethnocentricity-viewing the patient's culture inappropriately from the clinician's own perspective. In some senses, this applies to every clinical encounter-patient and clinician always come from different cultures, in the broad sense. Sensitive clinicians develop expertise at bridging this cultural gap and seeing the patient's problems from the latter's viewpoint. However, more systematic investigation of beliefs and attitudes within a given culture can be pursued using the anthropological technique of ethnography. Ethnographic interviewing can yield qualitative data which can then be taken further in quantitative studies. To minimise the risks of ethnocentricity, it may be appropriate to analyse such data not using customary statistical methods but non-linear multivariate data analysis.
关于疾病、其病因及治疗的大众观念，未必与医学知识相符，有时可能极具独特性。这些观念可能会对寻求帮助、患者对专业救助的态度以及患者参与疾病管理的方式产生影响。因此，临床医生需要了解这些大众观念和态度，以便让患者参与治疗并提供最佳护理。大众观念可能会受到个体文化的影响，进而也会受到种族群体的影响。在试图理解患者的观念时，研究者或临床医生存在以自我为中心的风险——从临床医生自身的角度不适当地看待患者的文化。从某种意义上说，这适用于每一次临床接触——广义上讲，患者和临床医生总是来自不同的文化。敏锐的临床医生会培养出弥合这种文化差距并从患者角度看待其问题的专业能力。然而，可以运用民族志这一人类学技术，对特定文化中的观念和态度进行更系统的调查。民族志访谈能够产生定性数据，这些数据随后可在定量研究中进一步深入分析。为尽量减少以自我为中心的风险，或许不宜使用传统统计方法，而应采用非线性多变量数据分析来分析此类数据。
