PubMed · 15061323
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Roger D Winland. Compassion.. https://pubmed.ncbi.nlm.nih.gov/15061323/
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OBJECTIVE: Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor-patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor-patient communication. In addition, a research model for studying this topic in future research is proposed. METHODS: A literature review using online databases (Pubmed, Psychlit) was performed. RESULTS: Findings reveal major differences in doctor-patient communication as a consequence of patients' ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients. CONCLUSION: Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor-patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients' preferences for doctor-patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective. PRACTICE IMPLICATIONS: Using a cultural sensitive approach in medical communication is recommended.
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The Swedish public healthcare sector is administered by county councils or regions with their own power of taxation. These authorities are facing difficult times as the gap between demand and healthcare resources is widening and the option to further increase county council taxes is not politically tempting. It is becoming ever more apparent that, sooner or later, limits to the public healthcare commitment must be set. In the north-western district of Region Skåne, the district board determined to initiate a public dialogue on prioritisation with local residents. Annual surveys were sent to 1% of the population ( approximately 2500 individuals) during the period 2002-2004. The addressees were also asked if they wanted to participate in public meetings with the healthcare politicians. This study investigates what happened to the preferences and attitudes of the interest group when the participants were not only offered an opportunity to enter into a dialogue with their peers and representatives, but also received information on prioritisation matters. After the intervention, which consisted of two public meetings with politicians and five information booklets on prioritisation issues, the study group was asked to participate in a second survey. At the follow-up, 20% fewer thought that one should always have a right to public healthcare, even if troubles were trivial. Eighty four percent in the study group thought that the general public should participate in prioritisation discussions while only 64% in the control group agreed to this. Eighty two percent of the study group marked the dialogue project "good" or "very good". The results indicate an increased acceptance for reallocations, a strengthened will to participate and more confidence in the politicians and their work. The study is descriptive and designed to make long-term follow-ups possible.