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“‘你只想给我开些药然后打发我走’:一个得到国家承认的部落成员对西药的偏好、信念及相关经历”

"'You Just Want to Give me Some Medicine and be on my Way': Preferences, Beliefs, and Experiences Related to Western Medication among Members of a State-Recognized Tribe".

作者信息

Reese Sarah E, Liddell Jessica L, Mascarena Laila

机构信息

University of Montana School of Social Work.

出版信息

J Holist Nurs. 2025 Jun;43(2):176-189. doi: 10.1177/08980101231219357. Epub 2024 Feb 28.

Abstract

Native American/American Indian (NA/AI) people have higher rates of chronic disease, including substance use and mental health disorders, compared to White Americans. Though pharmaceuticals can be helpful in addressing many chronic healthcare conditions, many people do not take medications as prescribed. NA/AI identity has been found to be associated with lower rates of medication adherence compared to White Americans. The purpose of this study is to better understand NA/AI women's perceptions, beliefs, and experiences related to medication. Thirty-one semi-structured interviews were conducted with NA/AI women from a state-recognized tribe located in the Gulf South. Interviews were transcribed and analyzed using a qualitative description approach. Eighteen women discussed their experiences using medications when asked about their healthcare experiences. Participants identified the following themes in their discussion of medication: (a) Cost of Medication as a Barrier; (b) Negative Side Effects of Western Medication; (c) Fear of Resistance and Dependence; (d) Preference for Traditional Medicine or None; and (e) Lack of Communication around Medications from Providers. Our findings support the growing call for cultural safety within medical settings and integrating NA/AI conceptualizations of health and well-being and traditional practices into western healthcare settings to better support NA/AI people.

摘要

与美国白人相比,美国原住民/美洲印第安人(NA/AI)患慢性病的比例更高,包括药物使用和心理健康障碍。尽管药物有助于治疗许多慢性健康问题,但许多人并未按规定服药。研究发现,与美国白人相比,NA/AI身份与较低的药物依从率相关。本研究的目的是更好地了解NA/AI女性对药物的看法、信念和经历。对来自墨西哥湾南部一个得到州认可的部落的NA/AI女性进行了31次半结构化访谈。访谈内容经转录后采用定性描述方法进行分析。当被问及她们的医疗经历时,18名女性讨论了她们使用药物的经历。参与者在讨论药物时确定了以下主题:(a)药物成本成为障碍;(b)西药的负面副作用;(c)对耐药性和依赖性的恐惧;(d)对传统药物或不服药的偏好;(e)与医疗服务提供者在药物方面缺乏沟通。我们的研究结果支持了在医疗环境中对文化安全的呼声越来越高,以及将NA/AI对健康和幸福的概念化以及传统做法融入西方医疗环境,以更好地支持NA/AI人群。

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