Marbella A M, Harris M C, Diehr S, Ignace G, Ignace G
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
Arch Fam Med. 1998 Mar-Apr;7(2):182-5. doi: 10.1001/archfami.7.2.182.
To gain an understanding of the prevalence, utilization patterns, and practice implications of the use of Native American healers together with the use of physicians, we conducted semistructured interviews at an urban Indian Health Service clinic in Milwaukee, Wisc, of a convenience sample of 150 patients at least 18 years old. The mean age of patients was 40 years, and the sex distribution was 68.7% women and 31.3% men. Thirty tribal affiliations were represented, the largest groups being Ojibwa (20.7%), Oneida (20.0%), Chippewa (11.3%), and Menominee (8.0%). We measured the number of patients seeing healers and gathered information on the types of healers, the ceremonies used for healing, the reasons for seeing healers, and whether patients discuss with their physicians their use of healers. We found that 38.0% of the patients see a healer, and of those who do not, 86.0% would consider seeing one in the future. Most patients report seeing a healer for spiritual reasons. The most frequently visited healers were herbalists, spiritual healers, and medicine men. Sweat lodge ceremonies, spiritual healing, and herbal remedies were the most common treatments. More than a third of the patients seeing healers received different advice from their physicians and healers. The patients rate their healer's advice higher than their physician's advice 61.4% of the time. Only 14.8% of the patients seeing healers tell their physician about their use. We conclude that physicians should be aware that their Native American patients may be using alternative forms of treatment, and they should open a respectful and culturally sensitive dialogue about this use with their patients.
为了解美国原住民治疗师与医生联合使用的患病率、使用模式及实际影响，我们在威斯康星州密尔沃基市的一家城市印第安健康服务诊所，对150名年龄至少18岁的便利样本患者进行了半结构化访谈。患者的平均年龄为40岁，性别分布为女性占68.7%，男性占31.3%。代表了30个部落归属，最大的群体是奥吉布瓦族（20.7%）、奥奈达族（20.0%）、奇佩瓦族（11.3%）和梅诺米尼族（8.0%）。我们统计了看治疗师的患者数量，并收集了有关治疗师类型、用于治疗的仪式、看治疗师的原因以及患者是否与医生讨论过他们使用治疗师的信息。我们发现38.0%的患者会看治疗师，而在那些不看治疗师的患者中，86.0%的人会考虑在未来去看。大多数患者表示看治疗师是出于精神方面的原因。最常去看的治疗师是草药治疗师、精神治疗师和巫医。发汗小屋仪式、精神治疗和草药疗法是最常见的治疗方式。超过三分之一看治疗师的患者从他们的医生和治疗师那里得到了不同的建议。61.4%的时间里，患者对治疗师建议的评价高于对医生建议的评价。看治疗师的患者中只有14.8%的人会告诉他们的医生自己使用治疗师的情况。我们得出结论，医生应该意识到他们的美国原住民患者可能正在使用替代治疗方式，并且他们应该就这种使用情况与患者展开尊重且具有文化敏感性的对话。
