Doctor-patient communication in Southeast Asia: a different culture?
Doctor-patient communication in Southeast Asia: a different culture?
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DOI：
10.1007/s10459-012-9352-5
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发表时间：
2013-03
期刊：
影响因子：
--
通讯作者：
van der Vleuten C
中科院分区：
文献类型：
--
作者：
Claramita M;Nugraheni MD;van Dalen J;van der Vleuten C
医患沟通研究普遍提倡伙伴式沟通方式。然而，在东南亚环境中，我们经常看到一种更加单向的风格，几乎没有患者的参与。我们调查了东南亚地区医生使用单向咨询方式的因素。我们根据扎根理论的原则进行了定性研究。印度尼西亚一家教学医院和两家附属医院的内科门诊对 20 名住院医师和专科医生以及 20 名低或高教育水平的患者进行了采访。在 26 周的时间里，我们进行了迭代访谈和编码过程，以识别突发因素。患者普遍对医生的沟通方式不满意。医生表示，他们并不是故意使用单向方式。沟通方式似乎与东南亚文化、医疗保健环境和医学教育的特征有关。医患沟通似乎受到文化特征的影响，文化特征分为代表东南亚文化主要特征的两大类，即“社交距离”和“关系的亲密程度”，以及“特定临床背景”的特征。考虑这些特征可能有助于促进伙伴关系沟通方式的使用。
Studies of doctor–patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors’ communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor–patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, “social distance” and “closeness of relationships”, and to characteristics categorized as “specific clinical context”. Consideration of these characteristics could be helpful in promoting the use of a partnership communication style.
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