Personal Characteristics Associated with Resident Physicians' Self Perceptions of Preparedness to Deliver Cross-Cultural Care
Personal Characteristics Associated with Resident Physicians' Self Perceptions of Preparedness to Deliver Cross-Cultural Care
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DOI：
10.1007/s11606-008-0782-y
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发表时间：
2008-12-01
影响因子：
5.7
通讯作者：
Weissman, Joel S.
中科院分区：
文献类型：
--
作者：
Lopez, Lenny;Vranceanu, Ana-Maria;Weissman, Joel S.
背景技术背景：医学研究所最近的报告强调以病人为中心的护理和跨文化培训是提高医疗质量和消除种族和民族差异的一种手段。目的：确定住院医师的社会文化特征是否影响自我感知的准备和提供跨文化护理的技能，控制在医学院或住院期间接受的培训。参与者：在美国学术健康中心培训的最后一年的七个专业的居民的概率样本。测量：九个居民的特点进行了分析。准备和技能的差异进行了评估，使用卡方（2）统计和多元logistic regression.RESULTS：百分之五十八（2047/3500）的居民回答。在执行选定的任务或服务，被认为是有用的，在治疗文化多样性的患者，与提高感知技能水平相关的最重要的因素是在住院期间接受过跨文化技能培训（OR范围1.71-4.22）。与白色居民相比，非洲裔美国医生更愿意与对美国医疗体系不信任的患者打交道（OR 1.63）和少数种族或族裔（OR 1.61），拉丁裔人报告说，他们对与新移民打交道感到更有准备（OR 1.88）和亚洲人表示，他们在应对健康信念与西医不一致的患者时感觉更有准备（1.43）.结论：跨文化护理技能培训与增加自我感知准备照顾不同的患者人群，提供支持的重要性，这种培训在研究生医学教育。此外，选定的居民特征与准备或多或少的跨文化护理的不同方面有关，这强调了需要在所有的培训计划中包括来自不同背景的医疗居民，并根据居民个人的需求定制这些计划，以最大限度地提高这种培训可能对护理质量产生影响的机会。
BACKGROUND: Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities.OBJECTIVE: To determine whether, controlling for training received in medical school or during residency, resident physician socio-cultural characteristics influence self-perceived preparedness and skill in delivering cross-cultural care.DESIGN: National survey of resident physicians.PARTICIPANTS: A probability sample of residents in seven specialties in their final year of training at US academic health centers.MEASUREMENT: Nine resident characteristics were analyzed. Differences in preparedness and skill were assessed using the chi(2) statistic and multivariate logistic regression.RESULTS: Fifty-eight percent (2047/3500) of residents responded. The most important factor associated with improved perceived skill level in performing selected tasks or services believed to be useful in treating culturally diverse patients was having received cross-cultural skills training during residency (OR range 1.71-4.22). Compared with white residents, African American physicians felt more prepared to deal with patients with distrust in the US healthcare system (OR 1.63) and with racial or ethnic minorities (OR 1.61), Latinos reported feeling more prepared to deal with new immigrants (OR 1.88) and Asians reported feeling more prepared to deal with patients with health beliefs at odds with Western medicine (1.43).CONCLUSIONS: Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care.This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in order to maximize the chances that such training is likely to have an impact on the quality of care.