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Negotiating Engagement, Worthiness of Care and Cultural Identities Through Intersubjective Recognition: Migrant Patient Perspectives on the Cultural Formulation Interview in Danish Mental Healthcare
Culture, Medicine, and Psychiatry ( IF 2.333 ) Pub Date : 2020-11-10 , DOI: 10.1007/s11013-020-09694-2
Laura Glahder Lindberg 1, 2 , Katrine Schepelern Johansen 3 , Maria Kristiansen 2, 4 , Signe Skammeritz 1 , Jessica Carlsson 1, 5
Affiliation  

This qualitative study presents migrant patient perspectives on using the Cultural Formulation Interview (CFI) in mental health assessments in Denmark. Empirical data consisted of 20 recorded CFI sessions and 16 patient interviews, coded with a constructivist grounded theory approach. Empirical findings prompted us to draw on the theoretical framework of intersubjective recognition in the analytical process. Our analysis showed how patients had multiple previous experiences of misrecognition in life and healthcare. This seemed to restrain their self-esteem and available positions for expressing preferences and reservations during the CFI and led to negotiations of worthiness of care. Despite occasional lack of flow and information in the recorded CFI sessions, patients subsequently recounted how they felt the CFI recognised the complexity and context of their cultural identities and illness narratives. Patients described how the CFI-guided provider approach of curiosity and empowerment carried significant meaning and left them feeling dignified, hopeful and engaged in future care. Intersubjective recognition is fundamental in all human interaction, but we argue that the recognising CFI approach is particularly important in vulnerable and asymmetrical mental health assessment encounters where access to care is determined and when working with migrants or other marginalised groups.



中文翻译:

通过主体间识别来协商参与、护理的价值和文化身份:移民患者对丹麦精神卫生保健文化配方访谈的看法

这项定性研究展示了移民患者在丹麦心理健康评估中使用文化公式访谈 (CFI) 的观点。经验数据包括 20 次记录的 CFI 会议和 16 次患者访谈,采用建构主义扎根理论方法进行编码。实证结果促使我们在分析过程中利用主体间识别的理论框架。我们的分析表明,患者以前在生活和医疗保健方面有过多次误认的经历。这似乎限制了他们的自尊和在 CFI 期间表达偏好和保留的可用立场,并导致了对护理价值的谈判。尽管在记录的 CFI 会议中偶尔缺乏流量和信息,患者随后讲述了他们如何感觉 CFI 认识到他们的文化身份和疾病叙述的复杂性和背景。患者描述了 CFI 指导的好奇心和赋权的提供者方法如何具有重要意义,并使他们感到有尊严、充满希望并参与未来的护理。主体间识别是所有人类互动的基础,但我们认为,识别 CFI 方法在脆弱和不对称的心理健康评估遭遇中尤为重要,在这种情况下,确定获得护理的机会以及与移民或其他边缘化群体合作时。充满希望并从事未来的护理。主体间识别是所有人类互动的基础,但我们认为,识别 CFI 方法在脆弱和不对称的心理健康评估遭遇中尤为重要,在这种情况下,确定获得护理的机会以及与移民或其他边缘化群体合作时。充满希望并从事未来的护理。主体间识别是所有人类互动的基础,但我们认为,识别 CFI 方法在脆弱和不对称的心理健康评估遭遇中尤为重要,在这种情况下,确定获得护理的机会以及与移民或其他边缘化群体合作时。

更新日期:2021-01-13
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