A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes
A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes
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DOI：
10.1097/00001888-200306000-00006
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发表时间：
2003-06-01
影响因子：
7.4
通讯作者：
Kassim-Lakha, S
中科院分区：
文献类型：
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作者：
Kagawa-Singer, M;Kassim-Lakha, S
来自不同文化背景的医生和病人之间的接触变得越来越普遍。医生努力改善健康结果，提高每一个病人的生活质量，但这些不和谐的遭遇似乎是一个重要因素，超越社会经济障碍，在创造不平等的和可避免的过度疾病负担的少数民族人口在美国的成员承担。大多数临床医生缺乏了解文化如何影响临床遭遇的信息和有效弥合潜在差异的技能。需要新的战略来扩大医疗培训，以充分解决医生、患者和家庭之间文化上的不和谐，因为三者对疾病的性质、对治疗的期望以及语言之外的适当沟通模式可能有不同的概念。作者从人类学角度探讨了文化与健康之间的基本关系，并概述了医疗保健系统的社会和法律的结构所需的系统性变革，以减少跨文化误解的风险，并增加改善多元文化美国社会中所有人群健康状况的可能性。作者定义了每种文化中固有的优势，为临床医生提供了在其文化背景下评估疾病和疾病的指南，并概述了在潜在差异中进行谈判以达到共同期望的护理目标所需的临床技能。最后，他们指出，在卫生保健环境中，使和支持这种做法所需的结构性变化。
Encounters between physicians and patients from different cultural backgrounds are becoming commonplace. Physicians strive to improve health outcomes and increase quality of life for every patient, yet these discordant encounters appear to be a significant factor, beyond socioeconomic barriers, in creating the unequal and avoidable excess burden of disease borne by members of ethnic minority populations in the United States. Most clinicians lack the information to understand how Culture influences the clinical encounter and the skills to effectively bridge potential differences. New strategies are required to expand medical training to adequately address culturally discordant encounters among the physicians, their patients, and the families, for all three may have different concepts regarding the nature of the disease, expectations about treatment, and modes of appropriate communication beyond language. The authors provide an anthropological perspective of the fundamental relationship between culture and health, and outline systemic changes needed within the social and legal structures of the health care system to reduce the risk of cross-cultural miscommunication and increase the likelihood of improving health outcomes for all populations within the multicultural U.S. society. The authors define the strengths inherent within every culture, provide a guideline for the clinician to evaluate disease and illness within its cultural context, and outline the clinical skills required to negotiate among potential differences to reach mutually desired goals for care. Last, they indicate the structural changes required in the health care setting to enable and support such practice.