Cultural health capital and the interactional dynamics of patient-centered care
Cultural health capital and the interactional dynamics of patient-centered care
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DOI：
10.1016/j.socscimed.2013.06.014
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发表时间：
2013-09-01
影响因子：
5.4
通讯作者：
Shim, Janet K.
中科院分区：
文献类型：
--
作者：
Dubbin, Leslie A.;Chang, Jamie Suki;Shim, Janet K.
以病人为中心的护理概念虽然看起来很直观，也很吸引人，但却很难概念化、制度化和可操作化。通过布迪厄的文化资本和惯习的概念，我们采用文化健康资本的框架来揭示患者和提供者的文化资源，资产和互动风格影响他们相互实现以患者为中心的护理的能力的方式。文化健康资本被定义为在临床互动过程中，患者和提供者所重视、利用和交换的文化技能、态度、行为和干预风格的专门集合。在本文中，我们报告了2010年至2011年在美国西部进行的定性研究的结果。我们调查了文化健康资本的各种要素，患者和提供者如何利用文化健康资本相互参与，以及这一过程如何塑造以患者为中心的互动。我们发现，以病人为中心的医疗服务的成就是高度依赖于体质和文化的健康资本，病人和提供者带来的医疗保健互动。一些文化资源不仅比其他文化资源更受重视，而且它们的差异性动员可能促进或阻碍患者与其提供者之间的接触和沟通。文化健康资本对基本社会不平等在临床互动中表现的方式的关注使提供者，患者和医疗保健组织能够考虑这种不平等如何混淆以患者为中心的护理。(C)2013爱思唯尔有限公司保留所有权利。
As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. (C) 2013 Elsevier Ltd. All rights reserved.