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Their Physicians' Views

Julia Joseph-Di Caprio, MD, MPH; Ann W. Garwick, PhD; Claire Kohrman, PhD; Robert W. Blum, MD, PhD

Arch Pediatr Adolesc Med. 1999;153:1030-1035.

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.

Design  Qualitative study in 2 midwestern metropolitan areas.

Setting  General community.

Participants  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.

Conclusion  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.

From the Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minn (Dr Joseph-Di Caprio); Maternal and Child Health Program, University of Minnesota School of Public Health, Minneapolis (Dr Garwick); Department of Pediatrics, University of Chicago, Chicago, Ill (Dr Kohrman); and Division of General Pediatrics and Adolescent Health, University of Minnesota School of Medicine, Minneapolis (Dr Blum).

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