Doctoral Dissertation Research: Negotiating Care in Intercultural Integrative Medicine

为不同人群提供文化上适当的护理已成为卫生保健系统面临的重大挑战。在医疗保健专业人员中存在着关于在跨文化融合环境中适当的实践方法的激烈辩论。常见的办法包括培训传统助产士和将民族医疗实践纳入生物医疗设施。但关于跨文化沟通和医疗保健提供如何通过这些干预措施进行转变的重大问题仍然存在。这个项目培训研究生如何进行严格的、以经验为基础的科学田野工作，考察生物医学从业者如何在跨文化医疗保健环境中协商医疗权威和社会不平等。这项研究的结果将与医疗保健专业人员以及人类学家和其他对生物医学和医疗保健不平等研究感兴趣的社会科学家分享。这项研究的结果将被提交给参与的诊所，并通过英语和西班牙语的学术和非学术出版物、演示文稿和报告进行传播，目的是制定护理结果和改善跨文化卫生保健的战略。Trisha Netsch Lopez在凯瑟琳·德沃特博士的监督下，将探索在跨文化背景下提供卫生保健的冲突如何在卫生保健提供者之间的日常互动中隐含地反映、再现或矛盾。这项研究将在厄瓜多尔的一家跨文化卫生诊所进行，生物医学卫生专业人员因将跨文化卫生保健纳入分娩方法而得到国际认可。这项研究考察了适合文化的健康计划面临的最内在的挑战：谁有权定义文化的作用、参与的限制以及此类计划的直接和间接受益者。它还将通过结合语言学和人种学的方法来探索健康和日常护理遭遇的政治话语的交集，从而对医学和语言人类学做出重要贡献。这项研究将结合对产妇保健预约的定量和定性语言分析、政策文件分析和对保健提供者、卫生官员、土著活动家和社区成员的访谈。这种方法的结合使得能够进行多层次的分析，以了解跨文化交流行为如何受到文化上适当的卫生保健和土著权利的政治话语的影响，以及患者、提供者和周围社区的需求和观点。

Providing culturally appropriate care for diverse populations has become a significant challenge for health care systems. There is significant debate among healthcare professionals about appropriate methods of practice in intercultural integrative settings. Common approaches have included training traditional birth attendants and incorporating ethnomedical practices within biomedical facilities. But significant questions remain about the how intercultural communication and healthcare delivery are transformed through these interventions. This project, which trains a graduate student in how to conduct rigorous, empirically-grounded scientific fieldwork, examines how biomedical practitioners negotiate medical authority and social inequalities within intercultural healthcare settings. The results of this research will be shared with healthcare professionals, and among anthropologists and other social scientists interested in studies of biomedicine and healthcare inequalities. Findings from this study will be presented to the participating clinic, and disseminated through academic and non-academic publications, presentations, and reports in English and Spanish with the aim of developing care outcomes and strategies for improving intercultural health care.Trisha Netsch Lopez, under the supervision of Dr. Kathleen DeWalt, will explore how conflicts over the delivery of healthcare in intercultural contexts are reflected, reproduced, or contradicted implicitly within everyday interactions between healthcare providers. The study will take place at an intercultural health clinic in Ecuador, a setting internationally recognized by biomedical health professionals for its inclusion of intercultural healthcare in delivery methods. This research examines the most intrinsic challenges to culturally appropriate health programs: who has the authority to define the role of culture, the limits of participation, and the direct and indirect beneficiaries of such programs. It will also make important contributions to medical and linguistic anthropology by combining linguistic and ethnographic methods to explore the intersection of political discourses of health and everyday care encounters. The study will combine quantitative and qualitative linguistic analyses of maternal health appointments with policy document analysis and interviews with health care providers, health officials, indigenous activists, and community members. This combination of methods allow for a multi-level analysis to understand how the act of intercultural communication shapes/is shaped by political discourses of culturally appropriate health care and indigenous rights, as well as the needs and viewpoints of patients, providers, and the surrounding community.