Professional uncertainty and disempowerment responding to ethnic diversity in health care: A qualitative study

PLoS Medicine

Volumn 4, Issue 11, 2007, Pages 1766-1775

  Kai, Joe ^a   Beavan, Jackie ^a   Faull, Christina ^b   Dodson, Lynne ^c   Gill, Paramjit ^d   Beighton, Angela ^a  

^a UNIVERSITY OF NOTTINGHAM   (United Kingdom)

^b Leicestershire and Rutland Organisation for the Relief of Suffering   (United Kingdom)

^c Birmingham Heartlands Teach Hosp   (United Kingdom)

^d UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; CLINICAL PRACTICE; CONTROLLED STUDY; ETHNICITY; HEALTH CARE; HEALTH CARE NEED; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HUMAN; HUMAN EXPERIMENT; NORMAL HUMAN; QUALITATIVE RESEARCH; RACISM; RISK ASSESSMENT; ANXIETY; ATTITUDE TO HEALTH; BEHAVIOR; CULTURAL ANTHROPOLOGY; FEMALE; HEALTH PERSONNEL ATTITUDE; INFORMATION PROCESSING; MALE; MIDDLE AGED; PSYCHOLOGICAL ASPECT; SOCIAL PSYCHOLOGY; UNITED KINGDOM;

ADULT; AGED; ANXIETY; ATTITUDE OF HEALTH PERSONNEL; ATTITUDE TO HEALTH; CULTURAL DIVERSITY; FEMALE; FOCUS GROUPS; GREAT BRITAIN; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH PERSONNEL; HUMANS; MALE; MIDDLE AGED; POWER (PSYCHOLOGY); QUALITATIVE RESEARCH; QUALITY OF HEALTH CARE; STEREOTYPING;

EID: 36849054594     PISSN: 15491277     EISSN: 15491676     Source Type: Journal    
DOI: 10.1371/journal.pmed.0040323     Document Type: Article

References (54)

1. Office for National Statistics (Updated 2005). Resident population by ethnic group 2001/2. www.statistics.gov.uk/census2001. Accessed 2 February 2007.
2. US Census Bureau (2000). Profile of general demographic characteristics. www.census.gov/main/www/cen2000. Accessed 2 February 2007.
3. Acheson D (1998) Independent inquiry into inequalities in health. London: The Stationary Office.
4. Davey Smith G, Chaturvedi N, Harding S, Nazroo J, Williams R (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Crit Public Health 10: 375-408.
5. Smedley BD, Stith AY, Nelson AR (2003) Unequal Treatment: confronting racial and ethnic disparities in health care. Washington (D. C.): Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care.
6. Smaje C (1995) Health, "race" and ethnicity: making sense of the evidence. London: Kings Fund.
7. Nazroo JY (1997) The health of Britain's ethnic minorities. London: Policy Studies Institute.
8. Trevino FM (1999) Quality of health care for ethnic/racial minority populations. Ethn Health 4: 153-164.
9. Feder G, Crook AM, Magee P, Banerjee S, Timmis AD, et al. (2002) Ethnic differences in invasive management of coronary disease: prospective cohort study of patients undergoing angiography. BMJ 324: 511-516.
10. Fiscella K, Franks P, Gold MR, Clancy CM (2000) Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA 283: 2579-2584.
11. [No author listed] (2000) Race Relations (Amendment) Act 2000. Available: http://www.opsi.gov.uk/acts/acts2000. Accessed 18 October 2007.
12. US Department of Health and Human Services (2000) Healthy people 2010. Washington (D. C.): Government Printing Office. Available: http://www. healthypeople.gov/. Accessed 18 October 2007.
13. Gill PS, Kai J, Bhopal RS, Wild S (2007) Health care needs assessment: black and minority ethnic groups. In: Raftery J, Stevens A, Mant J, editors. Health care needs assessment. The epidemiologically based needs assesment reviews. 3rd series. Abingdon: Radcliffe Medical Press. Available: http://hcna.radcliffe-oxford.com/bemgframe.htm. Accessed 2 March 2007.
14. Szczepura A, Johnson MRD, Gumber G (2004) Review of the research evidence on ethnicity and communication. Coventry (UK): University of Warwick Centre for Health Services Studies.
15. Kai J, Spencer J, Woodward N (2001) Wrestling with ethnic diversity: toward empowering health educators. Med Educ 35: 262-271.
16. Brach C, Fraser I (2000) Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev 57: 181-217.
17. Kai J, Bridgewater R, Spencer J (2001) "'Just think of TB and Asians', that's all I ever hear": medical learners' views about training to work in an ethnically diverse society. Med Educ 35: 250-256.
18. Beach MC, Gary TL, Price EG, Robinson K, Gozu A, et al. (2006) Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions. BMC Public Health 6: 104.
19. Betancourt J (2004) Cultural competence - marginal or mainstream movement? N Engl J Med 351: 953-954.
20. Kleinman A (1981) Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley (CA): University of California Press. 427 p.
21. Helman C (2001) Culture, health and illness. 4th Ed. Butterworth Heinemann.
22. Like R, Steiner R, Rubel A (1996) Recommended core curriculum guidelines on culturally sensitive and competent health care. Fam Med 27: 219-297.
23. Betancourt J (2003) Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Acad Med 78: 560-569.
24. Campinha-Bacote J (2002) The process of cultural competence in the delivery of health care services: a model of care. J Transcult Nurs 13: 181-184.
25. Bigby J (2003) Cross-cultural medicine. Philadelphia: American College of Physicians.
26. Leininger M (1978) Transcultural nursing. Thorofare (NJ): Slack.
27. van Ryn M (2002) Research on the provider contribution to race/ethnicity disparities in medical care. Med Care 40: 140-151.
28. Kai J (2005) Professionals responding to cancer and ethnic diversity. London: Cancer Research UK.
29. Selby P (1996) Cancer clinical outcomes for minority ethnic groups. Br J Cancer Suppl 29: S54-60.
30. Kitzinger J (1994) The methodology of focus groups: the importance of interaction between research participants. Sociol Health Illn 16: 103-120.
31. Strauss A, Corbin J (1990) Basics of qualitative research: grounded theory procedures and techniques. Newbury Park (CA): Sage Publications.
32. Bloor M (1997) Techniques of validation in qualitative research: a critical commentary. In: Miller D, Dingwall R, editors. Context and method in qualitative research. London: Sage.
33. McNeil BJ (2001) Hidden barriers to improvement in the quality of care. N Engl J Med 345: 1612-1620.
34. Djulbegovic B (2004) Lifting the fog of uncertainty from the practice of medicine. BMJ 329: 1419-1420.
35. Griffiths F, Green E, Tsouroufli M (2005) The nature of medical evidence and its inherent uncertainty for the clinical consultation: qualitative study. BMJ 330: 7490.
36. Innes AD, Campion PD, Griffiths FE (2005) Complex consultations and the "edge of chaos." Br J Gen Pract 55: 47-52.
37. Fadiman A (1998) The spirit catches you and you fall down: a Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus and Giroux.
38. Kai J (2006) Valuing diversity. 2nd Ed. London: Royal College of General Practitioners.
39. Bowler I (1993) They're not the same as us: midwives' stereotypes of South Asian descent maternity patients. Soc Sci Med 15: 157-178.
40. van Ryn M, Burke J (2000) The effect of patient race and socio-economic status on physicians' perceptions of patients. Soc Sci Med 50: 813-828.
41. MacPherson W (1999) Report for the Stephen Lawrence enquiry. London: The Stationary Office.
42. Pendleton DA, Bochner S (1980) The communication of medical information in general practice consultations as a function of patients' social class. Soc Sci Med [Med Psychol Med Sociol] 14A: 669-673.
43. Cartwright A (1967) Patients and their doctors. London: Routledge, Kegan Paul.
44. Stewart M (1984) Patient characteristics which are related to the doctor-patient interaction. Fam Pract 1: 30-36.
45. Lock M, Gordon D, editors (1988) Biomedicine examined. Boston: Kluwer.
46. Hahn R, Gaines A (1985) Physicians of Western medicine. Boston: Kluwer.
47. Geertz C (1983) Local knowledge. New York: Basic Books. 256 p.
48. Geertz C (1972) The interpretation of cultures. New York: Basic Books. 480 p.
49. Kai J, Spencer J, Wilkes M, Gill P (1999) Learning to value ethnic diversity - what, why and how? Med Educ 33: 616-623.
50. Kleinman A (1988) The illness narratives: suffering, healing and the human condition. New York: Basic Books. 304 p.
51. Christakis N (1995) The similarity and frequency of proposals to reform medical education: constant concerns. JAMA 274: 706-711.
52. Bischoff A, Perneger TV, Bovier PA, Loutan L, Stalder H (2003) Improving communication between physicians and patients who speak a foreign language. Br J Gen Pract 53: 541-546.
53. Harmsen H, Bernsen R, Meeuwesen L, Thomas S, Dorrenboom G, et al. (2005) The effect of educational intervention on intercultural communication: results of a randomised controlled trial. Br J Gen Pract 55: 343-350.
54. Roberts C, Moss B, Wass V, Sarangi S, Jones R (2005) Misunderstandings: a qualitative study of primary care consultations in multilingual settings, and educational implications. Med Educ 39: 465-475.