The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service.

Détails

Ressource 1Télécharger: BIB_475E0B7A13D2.pdf (451.58 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_475E0B7A13D2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service.
Périodique
BMC health services research
Auteur(s)
Dominicé Dao M., Inglin S., Vilpert S., Hudelson P.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Statut éditorial
Publié
Date de publication
11/01/2018
Peer-reviewed
Oui
Volume
18
Numéro
1
Pages
19
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Training health professionals in culturally sensitive medical interviewing has been widely promoted as a strategy for improving intercultural communication and for helping clinicians to consider patients' social and cultural contexts and improve patient outcomes. Clinical ethnography encourages clinicians to explore the patient's explanatory model of illness, recourse to traditional and alternative healing practices, healthcare expectations and social context, and to use this information to negotiate a mutually acceptable treatment plan. However, while clinical ethnographic interviewing skills can be successfully taught and learned, the "real-world" context of medical practice may impose barriers to such patient-centered interviewing. Creating opportunities for role modeling and critical reflection may help overcome some of these barriers, and contribute to improved intercultural communication in healthcare. We report and reflect on a retrospective analysis of 10 years experience with a "cultural consultation service" (CCS) whose aim is to provide direct support to clinicians who encounter intercultural difficulties and to model the usefulness of clinical ethnographic interviewing for patient care.
We analyzed 236 cultural consultation requests in order to identify key patient, provider and consultation characteristics, as well as the cross cultural communication challenges that motivate health care professionals to request a cultural consultation. In addition, we interviewed 51 clinicians about their experience and satisfaction with the CCS.
Requests for cultural consultations tended to involve patient care situations with complex social, cultural and medical issues. All patients had a migration background, two-thirds spoke French less than fluently. In over half the cases, patients had a high degree of social vulnerability, compromising illness management. Effective communication was hindered by language barriers and undetected or underestimated patient/provider differences in health-related knowledge and beliefs. Clinicians were highly satisfied with the CCS, and appreciated both the opportunity to observe how clinical ethnographic interviewing is done and the increased knowledge they gained of their patients' context and perspective.
A cultural consultation service such as ours can contribute to institutional cultural competence by drawing attention to the challenges of caring for diverse patient populations, identifying the training needs of clinicians and gaps in resource provision, and providing hands-on experience with clinical ethnographic interviewing.

Mots-clé
Clinical ethnography, Cultural consultation, Cultural formulation, Intercultural communication
Pubmed
Web of science
Open Access
Oui
Création de la notice
27/01/2018 11:00
Dernière modification de la notice
08/05/2019 18:00
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