Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.
Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.
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DOI：
10.1186/1472-6963-13-460
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发表时间：
2013-11-04
影响因子：
2.8
通讯作者：
Thompson SC
中科院分区：
文献类型：
--
作者：
Shahid S;Durey A;Bessarab D;Aoun SM;Thompson SC
与非土著居民相比，澳大利亚土著居民患癌症的后果更差。在了解土著澳大利亚人对癌症的看法及其接受癌症服务的经验方面取得了一些进展。然而，很少有人知道的癌症服务提供者（CSP）的想法和土著病人的看法和他们的经验提供最佳的癌症护理土著人民。土著病人与非土著保健服务提供者之间的沟通被认为是土著人取得良好健康成果的一个障碍。本文报道了社区服务提供者对影响沟通的因素的看法，并为促进与西澳大利亚州土著患者的有效沟通提供了实用的策略。2006年3月至2007年9月和2011年4月至10月期间，对来自西澳大利亚州的62名土著和非土著社区服务提供者进行了深入访谈。社区服务提供者被要求与土著患者和患有癌症的家庭分享他们的经验。进行了专题分析。我们的分析主要以社会生态模型为基础，但白人和特权以及文化安全的概念也指导了我们的分析。社区服务提供者对土著癌症患者的需求缺乏了解，土著病人对西方医疗系统的了解有限，这被认为是沟通的两个主要障碍。为了有效地进行医患沟通，需要注意语言、沟通方式、医学术语的知识和使用以及时间概念的跨文化差异。土著人在主流社会中的边缘化以及土著人对卫生系统的不信任也是影响沟通的关键问题。土著病人与提供者之间有效沟通的潜在解决办法包括招聘更多的土著工作人员，为社区服务提供者提供适当的文化培训，对土著利益攸关方进行癌症教育，护理的连续性，避免使用医学术语，满足病人的心理社会和后勤需求，以及在职协调。个别社区卫生服务提供者查明了跨文化交流方面的挑战，以及他们愿意在更广泛的保健系统内满足特定文化的需要，包括与土著病人进行更好的交流。然而，与会者的意见表明，在系统一级缺乏协调一致的努力，以解决土著人在癌症结果方面的不利地位。
Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination. Individual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes.
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影响因子：
2.6
作者：
Downing, Rosie;Kowal, Emma;Paradies, Yin
通讯作者：
Paradies, Yin
影响因子：
3.1
作者：
DeSouza, Ruth
通讯作者：
DeSouza, Ruth
影响因子：
2.8
作者：
Shahid, Shaouli;Finn, Lizzie;Thompson, Sandra C.
通讯作者：
Thompson, Sandra C.
影响因子：
11.4
作者：
Coory, Michael D.;Green, Adele C.;Valery, Patricia C.
通讯作者：
Valery, Patricia C.
影响因子：
11.4
作者：
Anderson, Kate;Devitt, Jeannie;Cass, Alan
通讯作者：
Cass, Alan