How Applicable are Western Models of Patient-Physician Relationship in Asia?: Changing Patient-Physician Relationship in Contemporary Japan
How Applicable are Western Models of Patient-Physician Relationship in Asia?: Changing Patient-Physician Relationship in Contemporary Japan
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DOI：
10.1111/j.1475-6781.2005.00070.x
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发表时间：
2005-11-01
影响因子：
1.2
通讯作者：
Yamazaki, Yoshihiko
中科院分区：
文献类型：
--
作者：
Ishikawa, Hirono;Yamazaki, Yoshihiko
在过去的几十年里，围绕医患关系的社会和政治环境在日本一直在变化。本文旨在通过与西方国家的比较，说明日本医患关系现状和问题背后的社会和文化因素，并思考如何在日本以及其他亚洲文化中应用和培养相互参与的医患关系模式。本文讨论了与日本医患关系有关的四个主要社会文化因素：（1）个人主义与集体主义;（2）低背景与高背景;（3）女性与男性;（4）基督教与儒家。在讨论日本医患关系的相互参与模式时，出现了两个关键问题：家庭和沟通方式。日本的病人自主权应放在病人、家属和医生的三元关系中加以考虑。此外，由于日本和西方国家之间的沟通风格可能不同，沟通培训计划和医疗专业人员以及患者的干预措施应该以文化上适当的方式进行调整，以改善医疗交流，实现相互参与。除了倡导患者自主权之外，还应在我们的社会和文化背景下追求医患关系的相互参与模式，以使日本的患者和医生真正富有成效。
The social and political environments surrounding patient-physician relationship have been changing in Japan for the last few decades. This paper aims to illustrate social and cultural factors that underlie current situations and problems of patient-physician relationship in Japan through a comparison with those in western countries, and to consider how mutual participation model of patient-physician relationship could be applied and fostered in Japan as well as other Asian cultures. Four major sociocultural factors are discussed in relation to the patient-physician relationship in Japan: (1) individualism versus collectivism; (2) low context versus high context; (3) femininity versus masculinity; and (4) Christianity versus Confucianism. Two key issues in discussing the mutual participation model of patient-physician relationship in Japan have emerged; the family and the communication style. The patient autonomy in Japan should be considered within the context of the triadic relationship of patient, family, and physician. Also, since the communication style might differ between Japan and western countries, communication training programs and interventions for medical professionals as well as for patients should be tailored in a culturally appropriate way in order to improve the communication in medical encounters and to achieve the mutual participation. Beyond mere advocacy of the patient autonomy, the mutual participation model of patient-physician relationship should be pursued within our social and cultural context to be truly fruitful for patients and physicians in Japan.