Viewpoint: Cultural competence and the African American experience with health care: The case for specific content in cross-cultural education
Viewpoint: Cultural competence and the African American experience with health care: The case for specific content in cross-cultural education
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DOI：
10.1097/acm.0b013e31802d92ea
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发表时间：
2007-02-01
影响因子：
7.4
通讯作者：
Ellis, Glenn
中科院分区：
文献类型：
--
作者：
Eiser, Arnold R.;Ellis, Glenn
在少数族裔或种族患者的护理中实现文化能力是一个多方面的项目，涉及特定的文化知识以及更一般的技能和态度调整，以促进临床接触中的跨文化沟通。作者利用非裔美国患者的重要例子，研究了与提供文化上合格的医疗保健相关的相关历史和文化信息。作者确定了关键影响，包括奴隶制的遗留问题、吉姆·克劳歧视、塔斯基吉梅毒研究、宗教与医疗保健的相互作用、家庭疗法的使用、不信任、种族和谐与不和谐以及健康素养。作者提出，对有关民族和种族的特定信息的认识可以增强跨文化交流，并通过提供另一种文化中疾病的历史和社会背景来提高医生和其他医疗保健提供者的文化能力。文化教育本质上是模块化的，可以针对由医生团体和提供者组织服务的特定人群。教育方法应包括有关相关社会群体历史的信息以及一些情感交流特定文化需求的体验成分。作者描述了有助于弥合跨文化临床沟通差距的特殊技术，这些差距是由患者的不信任、缺乏文化理解、不同的疾病范式和健康文盲造成的。
Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care. The authors identify key influences, including the legacy of slavery, Jim Crow discrimination, the Tuskegee syphilis study, religion's interaction with health care, the use of home remedies, distrust, racial concordance and discordance, and health literacy. The authors propose that the awareness of specific information pertaining to ethnicity and race enhances cross-cultural communication and ways to improve the cultural competence of physicians and other health care providers by providing a historical and social context for illness in another culture. Cultural education, modular in nature, can be geared to the specific populations served by groups of physicians and provider organizations. Educational methods should include both information about relevant social group history as well as some experiential component to emotively communicate particular cultural needs. The authors describe particular techniques that help bridge the cross-cultural clinical communication gaps that are created by patients' mistrust, lack of cultural understanding, differing paradigms for illness, and health illiteracy.