Specificity of clinical breast examination in community practice.
Specificity of clinical breast examination in community practice.
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社区实践中临床乳房检查的特异性。
DOI：
10.1007/s11606-006-0062-7
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发表时间：
2007
影响因子：
5.7
通讯作者：
Elmore,JoannG
中科院分区：
文献类型：
--
作者：
Fenton,JoshuaJ;Rolnick,SharonJ;Harris,EmilyL;Barton,MaryB;Barlow,WilliamE;Reisch,LisaM;Herrinton,LisaJ;Geiger,AnnM;Fletcher,SuzanneW;Elmore,JoannG
背景：聋人使用卫生保健服务的方式与普通人群不同，对其原因的研究很少。目的：更好地了解使用美国手语交流的聋人的卫生保健经历。设计：对美国3个城市的焦点小组讨论进行定性分析。我们引出了积极和消极遭遇的故事，以及改善卫生保健的建议。结果：沟通困难无处不在。恐惧、不信任和挫败感在参与者对医疗保健遭遇的描述中尤为突出。积极经验的特点是有医学经验的认证口译员、具有手语技能的卫生保健从业人员以及努力改善沟通的从业人员。许多与会者承认，他们对自己的合法权利了解有限，并没有为自己辩护。一些与会者认为，卫生保健从业者应该更多地了解耳聋的社会文化方面。结论：聋人报告使用卫生保健服务有困难。医生可以促进改变来改善这一点。未来的研究应该探索临床医生在与聋人合作时的观点，改善沟通的方法，以及教授聋人自我辩护技能和他们的合法权利的项目的影响。
BACKGROUND:People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons.OBJECTIVE:To better understand the health care experiences of deaf people who communicate in American Sign Language.DESIGN:Qualitative analyses of focus group discussions in 3 U.S. cities.PARTICIPANTS:Ninety-one deaf adults who communicate primarily in American Sign Language.MEASUREMENTS:We collected information about health care communication and perceptions of clinicians’ attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care.RESULTS:Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants’ descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness.CONCLUSIONS:Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights.