Some Anthropologic Aspects of the Physician-Patient Encounter with Pulmonary Tuberculosis in Western Mexico.

Javier E. García de Alba-García; Arthur J. Rubel; Carmella C. Moore; Mario Márquez-Amezcua; Silvia Casasola; Cristine Von Glascoe

2002, Number 2

<< Back Next >>

Gac Med Mex 2002; 138 (2)

Some Anthropologic Aspects of the Physician-Patient Encounter with Pulmonary Tuberculosis in Western Mexico.

García de Alba-García JE, Rubel AJ, Moore CC, Márquez-Amezcua M, Casasola S, Von Glascoe C

Full text

How to cite this article

Language: Spanish
References: 26
Page: 211-216
PDF size: 53.89 Kb.

ABSTRACT

The present work has as its purpose a description of the information exchanged during doctor-patient encounters immediately following diagnosis of pulmonary tuberculosis. To accomplish this nine such encounters were audiotape at two public health clinics in Guadalajara, Mexico. Communication of information and affect was evaluated by adapting the Roter interactional process analysis. Results show that the physician instructed the patient to behave in ways to prevent disease transmission while assuring patient recovery. Virtually lacking from these recordings is evidence of physician concern with the struggle patients experience to incorporate this regimen of directly observed therapy in to their daily lives. Because these sessions are managed by clinicians to encourage a unidirectional flow of information from physician to patient, the former fail to attain either patient cultural understanding of his/her disease process or comprehensive understanding of how he is affected she by the illness.

REFERENCES

1. Newman MT. Aboriginal New World epidemiology and medical care, and impact of Old World disease import. Am J Phys Anthropol 1976;45:667-672.
2. Flores y Troncoso F de A. Historia de la Medicina en México. Vol 1. IMSS México: 1992. p. 131-132.
3. Vareidis BP, Grosset J, de Kantor Y, Laszio A, Feiton M, et al. Laboratory evaluations of drug resistant tuberculosis. WHOITB/93.171. Ginebra.World Health Organization 1993.
4. Sepkowitz KA, Raffalli J, Riley L, Kiehn TE, Amstrong D. Tuberculosis in the AIDS era. Clin Microbiol Rev 1995;8:180-1999.
5. García GL, Valdespino GJL, Palacios MM, Mayar MME, García SC, Sepúlveda AJ. Tuberculosis y SIDA en México. Salud Pública Méx 1995;37:539-548.
6. Baer RD, et al. Cross-cultural perspectives on the common cold: Data from five populations. Human Org 199 ;58:251-260.
7. Menegoni L. Conceptions of tuberculosis and therapeutic choices in highland Chiapas, México. Med Anthropol Q 1996;10:381-401.
8. Nitcher M. Illness Semantics and International Health. The weak lungs/TB complex in the Philippines. Soc Sci Med 1994;38:649-663.
9. Wolfe H, Marmor M, Maslansky R, Nichols Simberkoff M, Des JD, Moss A. Tuberculosis knowledge among New York City injection drugs users. Am J Public Health 1995;85(7):985-988.
Mejía MJY, Carmona GE. Abandono del tratamiento antituberculoso. Factores Asociados. Rev Med IMSS 1995;33:481-485.
Martínez C. Factores que influyen en el abandono del tra-tamiento antituberculoso. Rev Med IMSS 1982;20:667-675.
Roter DL. Patient participation in the patient provider interaction: The effects of patient question qsking on the quality of interaction, satisfaction and compliance. Health Edu Monographs 1977. p. 281-315.
Roter DL. The Roter method of interaction process Analysis. Mimeo, 1991.
Secretaría de Salud Modificaciones a la Norma Oficial Mexicana. NOM-006-SSA2-1993. Para la prevención y el control de la tuberculosis pulmonar en la atención primaria a la salud en México. México, D.F. 23 de Junio, 2000.
Rey de Castro J, Portocarrero B. El cumplimiento del paciente tuberculoso en un centro particular y la importancia de programa de control de tuberculosis. Rev Peruana Epidemiol 1992;5:28-31.
Dressier WW, Campos BM, Dos-Santos JE. Culture, socioeconomic status, and physical and mental health in Brazil. Med Anthropol Q 1998;12:424-446.
Van der Werf T. Patient compliance with tuberculosis treatment in Ghana: factors influencing adherence to therapy. Tubercle. 1990;71:247-252.
Buchanan RJ. Compliance with tuberculosis drug regimens: incentivos and enablers offered by Public Health Departments. Am J Public Health 1997;87:2014-2017.
Abel EK. Taking the cure to the poor: patients responses to New York City´s Tuberculosis Program. 1894 to 1918. Am J Public Health 1997;87:1808-1815.
Bertakis BD, Roter D, Putman SM. Relationship of the medical interview style to patient satisfaction. J Fam Pract 1991;32:175.
Mata JJ. Integrating the clients perspective in planning tuberculosis education and treatment program in Honduras. Med Anthropol 1985;Winter:57-64.
Poss JE. The meanings of tuberculosis for Mexican migrant farm workers in the United States. Soc Sci Med 1998;42:195-202.
Rubel A, Garro L. Social and cultural factors in the successful control of tuberculosis. Public Health Rep 1992;107: 626-636.
Di Matteo MR, Di Nicola DD. Achieving patient compliance: the psychology of the health practitioner´s role. New York: Pergamon Press; 1982.
Bamhomm F, Adriaanse H. In search of factors responsible for noncompliance among tuberculosis patients in Wardhia District, India. Soc Sci Med 1992;34:291-306.
Martínez CF. El encuentro médico paciente. En: Viesca TC, Compiler. Apuntes del Curso de Antropología Médica UNAM. 1990. México, D.F., México