医療従事者の準備が整った状態で,異文化間の介護を提供できる
Joel S Weissman1, Joseph Betancourt, Eric G Campbell
1Institute for Health Policy and Department of Medicine, Massachusetts General Hospital, Boston 02114, USA. jweissman@partners.org
JAMA
|September 8, 2005
まとめ
レジデント医師は,異文化間のケアが重要だと考えているが,適切な訓練と準備が欠けている. 教育のギャップは,健康格差を減らすために,文化的な能力の向上の必要性を強調しています.
科学分野:
- 医療教育 医療教育について
- 健康の格差について
- 文化的能力 文化的能力
背景:
- Institute of Medicineのレポートでは,医療の格差に対処するために,異文化間のトレーニングを強調しています.
- 定住医の教育経験に関する理解は,異文化間のケアに関する理解は限られている.
研究 の 目的:
- クロスカルチャーケアに対する入院医の態度を評価する.
- 多様な患者集団へのケアを提供するための居住者の準備を評価する.
- 異文化訓練に関連する教育経験と環境を検証する.
主な方法:
- 2003年に,レジデント医師の最終年度の3435人の層別ランダムサンプルにアンケートが行われました.
- 参加者は,米国の学術保健センターの様々な専門分野を代表しました.
- 応答率は60% (2047人の医師) でした.
主要な成果:
- 住民の96%は,文化的な問題に取り組むことが重要だと考えました.
- 8%は一般的に準備ができていないと感じているが,高い割合は特定の分野 (例えば,異なる健康信念を持つ患者,移民) で準備ができていない.
- 重要な部分では,異文化介護の訓練 (33-50%) と評価 (41-83%) が不十分であると報告し,時間不足とロールモデルが障壁であると指摘した.
結論:
- レジデント医師が自己報告した,異文化介護に対する準備は,臨床/技術的なスキルの準備よりも著しく低い.
- 認知された重要性にもかかわらず,クロスカルチャーケアは,在住期間中に限られた時間,トレーニング,評価,ロールモデリングを受けます.
- 人種・民族の健康格差を効果的に減らすために,多文化教育の大幅な改善が必要である.
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