Culture and the care of children with chronic conditions: their physicians' views.
BACKGROUND
Little is known about physicians' perceptions of the influence of culture on the health care of children with chronic and disabling conditions.


OBJECTIVE
To identify physicians' perceptions of the impact of the family's ethnocultural background on the health care of school-aged children with chronic conditions and recommendations for improving care.


METHODS
Qualitative study in 2 midwestern metropolitan areas.


METHODS
General community.


METHODS
Convenience sample of 52 physicians nominated by 60 African American, Hispanic, and European American families of school-aged children with chronic conditions.


METHODS
In-depth interviews were conducted with the physicians. Content analytic techniques were used to analyze the data.


RESULTS
In 44% of the responses, the physicians reported that ethnocultural background did not influence the care the child received, noting that comparable care was provided to all of their patients. In 14% of the responses, the effect was unknown. The overall effect was negative in 26% of the responses and positive in 16%. Physicians' recommendations focused on 4 topics: improving the training and education of health care professionals and families; ensuring good communication between the child, family, and health care professionals; supporting families; and improving the access and provision of services for children from diverse cultural backgrounds.


CONCLUSIONS
Although the majority of participants reported that ethnocultural background did not affect the care the child received from the health care system, physicians' recommendations reflected awareness of the influence of culture on the care of children with chronic conditions and the need for further training on this issue.
Joseph-Di Caprio
J
J
Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA. julia.joseph@co.hennepin.mn.us
Garwick
A W
AW
Kohrman
C
C
Blum
R W
RW
D001291:Attitude of Health Personnel; D002641:Chicago; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D002908:Chronic Disease; D003144:Communication Barriers; D003469:Culture; D006233:Persons with Disabilities; D006301:Health Services Needs and Demand; D006801:Humans; D008910:Minnesota; D010372:Pediatrics / Q000193:education; D011368:Professional-Family Relations; D011787:Quality of Health Care; D012944:Social Support