Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?
Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?
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DOI：
10.1016/j.socscimed.2006.06.005
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发表时间：
2006-11-01
影响因子：
5.4
通讯作者：
Bruijnzeels, Marc A.
中科院分区：
文献类型：
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作者：
Meeuwesen, Ludwien;Harmsen, Johannes A. M.;Bruijnzeels, Marc A.
本研究的目的是更深入地了解荷兰全科医生实践中跨文化咨询的医疗沟通模式的关系方面。我们问是否有差异，荷兰的全科医生与移民和荷兰患者的口头互动。数据来自144名成年患者的访谈和患者与31名荷兰全科医生之间的视频观察。患者组包括61名非西方移民（土耳其人，摩洛哥人，马达加斯加人，安的列斯人，佛得角人）和83名荷兰参与者。使用Roter的交互分析系统（RIAS）评估了言语交际的情感和工具方面。患者的文化背景通过种族，语言能力，教育水平，宗教信仰和文化观点（更传统或更现代）进行评估。与非西方移民患者（特别是来自土耳其和摩洛哥的患者）的会诊时间缩短了2分钟以上，与荷兰患者相比，全科医生与这些患者之间的权力距离更大。言语互动的主要差异是在情感行为维度上，而不是在工具维度上。医生在试图理解移民患者方面投入更多，而在荷兰患者的情况下，他们表现出更多的参与和同情。荷兰病人在医疗对话中似乎更自信。从患者的种族背景、文化观点（如宗教信仰）和语言障碍方面讨论了差异。它的结论是，注意文化多样性的问题，因为这会导致不同的医疗通信模式。双向策略，建议改善医疗沟通，与医生和病人的行为的影响。(c)2006爱思唯尔有限公司保留所有权利。
The aim of this study was to gain deeper insight into relational aspects of the medical communication pattern in intercultural consultations at GP practices in the Netherlands. We ask whether there are differences in the verbal interaction of Dutch GPs with immigrant and Dutch patients. Data were drawn from 144 adult patient interviews and video observations of consultations between the patients and 31 Dutch GPs. The patient group consisted of 61 non-Western immigrants (Turkish, Moroccan, Surinamese, Antillean, Cape Verdian) and 83 Dutch participants. Affective and instrumental aspects of verbal communication were assessed using Roter's Interaction Analysis System (RIAS). Patients' cultural background was assessed by ethnicity, language proficiency, level of education, religiosity and cultural views (in terms of being more traditional or more modern). Consultations with the non-Western immigrant patients (especially those from Turkey and Morocco) were well over 2 min shorter, and the power distance between GPs and these patients was greater when compared to the Dutch patients. Major differences in verbal interaction were observed on the affective behavior dimensions, but not on the instrumental dimensions. Doctors invested more in trying to understand the immigrant patients, while in the case of Dutch patients they showed more involvement and empathy. Dutch patients seemed to be more assertive in the medical conversation. The differences are discussed in terms of patients' ethnic background, cultural views (e.g. practicing a religion) and linguistic barriers. It is concluded that attention to cultural diversity does matter, as this leads to different medical communication patterns. A two-way strategy is recommended for improving medical communication, with implications for both doctor and patient behavior. (c) 2006 Elsevier Ltd. All rights reserved.