Cultural competence - A systematic review of health care provider educational interventions
Cultural competence - A systematic review of health care provider educational interventions
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DOI：
10.1097/01.mlr.0000156861.58905.96
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发表时间：
2005-04-01
期刊：
影响因子：
3
通讯作者：
Cooper, LA
中科院分区：
文献类型：
--
作者：
Beach, MC;Price, EG;Cooper, LA
目的：我们试图综合的研究结果，评估干预措施，以提高卫生专业人员的文化能力。设计：这是一个系统的文献综述和analysis.Methods：我们进行了电子和手工搜索，从1980年到2003年6月，以确定研究，评估干预措施，旨在提高卫生专业人员的文化能力。我们从研究中提取和综合了干预前和干预后的评估数据，或者有一个对照组进行比较，并将证据的强度分为优秀、良好、公平或较差，使用预定的标准。主要结果测量：我们寻求证据的有效性和成本的文化能力培训的卫生专业人员。有很好的证据表明，文化能力培训提高了卫生专业人员的知识（19项研究中有17项显示出有益效果），有很好的证据表明，文化能力培训提高了卫生专业人员的态度和技能（25项评估态度的研究中有21项显示出有益效果，14项评估技能的研究中有14项显示出有益效果）。有很好的证据表明文化能力培训影响患者满意度（3项研究中有3项显示出有益效果），缺乏证据表明文化能力培训影响患者依从性（尽管有一项研究显示出有益效果），并且没有研究评估患者健康状况结果。有贫穷的证据，以确定文化能力培训的成本（5项研究包括不完整的成本估计）。结论：文化能力培训显示承诺作为一种战略，提高知识，态度和技能的卫生专业人员。然而，缺乏证据表明它可以提高患者对治疗的依从性，健康结果以及种族和民族群体之间的服务公平性。未来的研究应侧重于这些结果，并应确定哪些教学方法和内容是最有效的。
Objective: We sought to synthesize the findings of studies evaluating interventions to improve the cultural competence of health professionals.Design: This was a systematic literature review and analysis.Methods: We performed electronic and hand searches from 1980 through June 2003 to identify studies that evaluated interventions designed to improve the cultural competence of health professionals. We abstracted and synthesized data from studies that had both a before- and an after-intervention evaluation or had a control group for comparison and graded the strength of the evidence as excellent, good, fair, or poor using predetermined criteria.Main Outcome Measures: We sought evidence of the effectiveness and costs of cultural competence training of health professionals.Results: Thirty-four studies were included in our review. There is excellent evidence that cultural competence training improves the knowledge of health professionals (17 of 19 studies demonstrated a beneficial effect), and good evidence that cultural competence training improves the attitudes and skills of health professionals (21 of 25 studies evaluating attitudes demonstrated a beneficial effect and 14 of 14 studies evaluating skills demonstrated a beneficial effect). There is good evidence that cultural competence training impacts patient satisfaction (3 of 3 studies demonstrated a beneficial effect), poor evidence that cultural competence training impacts patient adherence (although the one study designed to do this demonstrated a beneficial effect), and no studies that have evaluated patient health status outcomes. There is poor evidence to determine the costs of cultural competence training (5 studies included incomplete estimates of costs).Conclusions: Cultural competence training shows promise as a strategy for improving the knowledge, attitudes, and skills of health professionals. However, evidence that it improves patient adherence to therapy, health outcomes, and equity of services across racial and ethnic groups is lacking. Future research should focus on these outcomes and should determine which teaching methods and content are most effective.