Communication and Racial Disparities in Health Care

Communication and Racial Disparities in Health Care pdf epub mobi txt 电子书 下载 2026

出版者:Sage Pubns
作者:Perloff, Richard M 编
出品人:
页数:132
译者:
出版时间:2006-1
价格:$ 31.64
装帧:Pap
isbn号码:9781412940245
丛书系列:
图书标签:
  • 健康差距
  • 种族差异
  • 沟通
  • 医疗保健
  • 健康公平
  • 文化能力
  • 患者沟通
  • 少数族裔健康
  • 社会决定因素
  • 医疗服务可及性
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具体描述

Social class, race, and ethnicity all influence health care disparities for many health care services and illnesses, such as heart disease and stroke, cancer, diabetes, chronic kidney disease, and maternal and child health care. Public health scholars have advanced numerous reasons for these disparities, including physician biases, patients' fatalistic attitudes, cultural patterns, lack of health insurance, and institutional racism. Communication plays a critical role in conveying, reinforcing, and helping to reduce health care inequities. The eight articles in the February 2006 issue of American Behavioral Scientist explore how racial disparities in health care outcomes are related to communication issues. Article highlights include: Focusing on cancer-related health outcomes, the factors that contribute to racial disparities in health care and how various types of communication can both exacerbate problems and /or contribute to high-quality health care (Kreps). A discussion of tailored interventions in public health and insights from studies of multi-level, multi-component interventions designed to promote healthy eating and exercise among rural African-Americans (Kramish Campbell and Quintiliani). Using examples from campaigns designed to increase mammography use and the intake of fruits and vegetables among lower-income African-American women, how subtle culturally sensitive variations in tailoring communications directed at minority audiences can influence health promotion behavior (Kreuter and Haughton). Applying prospect theory and framing concepts to health communications directed at medically underserved populations and the complexities that arise from intersections ofmessage framing with program goals and cultural targeting (Schneider). Insights from 15 years of research on an interactive cancer communication program, the Comprehensive Health Enhancement Support System (CHESS), and the consistently positive effects on low-income African-American women's health information competence (Shaw, Gustafson, Hawkins, McTavish, McDowell, Pingree, and Ballard). Two papers that posit that doctors and minority patients frequently miss the mark due to physician perceptions, language barriers, and self-fulfilling prophecy spirals. The first paper includes an integrative perspective on doctor-patient communication and cultural competency. (Perloff, Bonder, Ray, Berlin Ray, and Siminoff); the second paper offers an incisive review of patient-centered communication and patient communication skills training (Cegala and Post). The empirical and moral assumptions surrounding segmentation campaigns designed to reduce racial disparities, including different strategies to build racial segmentation into campaigns, ethical and political quandaries, and contexts in which segmentation may not be the best approach (Hornik and Ramirez). Taken together, these eight articles provide new directions for research on communication and racial disparities. They also provide thoughtful suggestions for campaign practitioners. This incisive issue of American Behavioral Scientist should be in the library of everyone interested in health communication, health disparities, health promotion, minority health, cultural competency training, doctor-patient communication, and public health.

《沟通与医疗保健中的种族差异》是一本深刻探索医疗保健领域中沟通障碍如何加剧和维持种族不平等的著作。本书并非简单罗列数据或陈述显而易见的事实,而是深入剖析了沟通在医疗决策、医患关系、健康知识传播以及医疗政策制定等各个环节中扮演的关键角色,并系统性地揭示了这些沟通环节如何被根深蒂固的种族偏见所影响,最终导致不同种族群体在健康结果上出现显著差异。 本书作者并非仅仅关注语言障碍,而是将“沟通”的概念拓宽到更广泛的范畴。这包括了语言的选择与使用,非语言线索的解读,文化背景对沟通风格的影响,以及信息传递的准确性和可及性。更重要的是,本书深入探讨了“隐性偏见”和“系统性歧视”如何在不经意间渗透到医疗沟通中,即使医疗专业人员本身可能并未意识到。例如,医生对特定种族患者的刻板印象可能导致其在诊断和治疗方案的选择上产生微妙但重要的偏差,从而影响患者的健康体验和预后。 全书的研究视角是多维度的。作者首先从微观层面着手,详细分析了医患互动中的具体沟通场景。这包括了病史采集时,患者因为不信任或恐惧而隐瞒信息,或者医生因为先入为主的观念而未能充分倾听患者的担忧。书中通过大量的案例研究和访谈,生动地展现了当患者的文化背景、社会经济地位与医生所处的环境存在差异时,沟通会遭遇怎样的挑战。例如,对某些文化群体而言,直接表达身体不适可能被视为不敬,而医生如果对此缺乏了解,就可能错过重要的诊断线索。同样,语言障碍不仅仅是使用不同语言,还包括了医学术语的专业性和复杂性,这使得非母语患者或文化水平较低的患者在理解医嘱时更加困难,进而影响治疗的依从性。 在宏观层面,本书还审视了医疗系统内部的沟通机制。这包括了不同医疗机构之间信息传递的效率和准确性,以及医疗团队内部沟通的流畅程度。当患者从初级保健医生转诊到专科医生时,信息的丢失或误解可能会延误治疗。而当不同专业背景的医护人员在交流中出现障碍时,也可能影响对患者的整体评估和护理方案的制定。作者尤其强调了历史遗留下来的种族主义政策和实践,如何在医疗机构的制度设计中留下印记,导致资源分配不均,以及对某些族裔群体提供次等医疗服务。这些制度性的障碍,虽然不直接是“沟通”本身,但却深刻地塑造了沟通的发生环境和内容,并最终导致了健康差异。 本书对“种族”的理解也并非停留在简单的肤色或民族划分,而是将其视为一个复杂的社会建构,与权力、历史、经济地位和社会经历紧密相连。作者认为,种族差异在医疗领域中的体现,往往是社会不平等在健康领域的映射。因此,要解决医疗保健中的种族差异,就必须直面沟通中的偏见,同时也要关注更广泛的社会经济因素对健康的影响。 本书的价值在于其提出的解决方案具有前瞻性和可操作性。作者并非仅仅指出问题,而是积极倡导一系列改善沟通和减少种族差异的策略。这包括了对医疗专业人员进行跨文化能力培训,提升他们对不同文化背景患者的理解和沟通技巧;推广使用专业的医疗翻译和文化协调员,确保语言和文化障碍得到有效克服;开发更易于理解的健康信息材料,并采用多种渠道进行传播,以提高健康素养;以及呼吁医疗机构改革政策,消除系统性歧视,确保所有患者都能获得公平、高质量的医疗服务。 此外,本书还强调了患者赋权的重要性。作者认为,患者应该被视为医疗过程中的积极参与者,他们的声音应该被倾听,他们的选择应该被尊重。通过加强患者的健康素养,鼓励他们主动与医疗专业人员沟通,提出疑问,并参与到治疗决策中,可以有效地缩小信息不对称,并减少因沟通不畅而产生的误解和不信任。 《沟通与医疗保健中的种族差异》是一本极具洞察力的著作,它迫使读者重新审视我们在医疗保健环境中进行的每一次对话,每一次互动。它提醒我们,有效的沟通不仅仅是传递信息,更是建立信任、体现尊重、并最终促进健康的基石。对于任何关心公平、正义以及提升全民健康水平的人而言,本书都将是一次深刻而发人深省的阅读体验。它不仅为学者和政策制定者提供了丰富的研究基础和政策建议,也为医疗专业人员提供了宝贵的实践指导,更有助于普通大众理解医疗保健领域中存在的深层问题,并积极参与到解决这些问题的进程中来。本书所揭示的沟通挑战与种族差异之间的错综复杂的关系,为我们指明了通往更公平、更健康未来的方向。

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