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Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala

Overview of attention for article published in Journal of Ethnobiology and Ethnomedicine, August 2017
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  • Good Attention Score compared to outputs of the same age (68th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (60th percentile)

Mentioned by

policy
1 policy source
twitter
1 tweeter
facebook
2 Facebook pages

Citations

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6 Dimensions

Readers on

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58 Mendeley
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Title
Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala
Published in
Journal of Ethnobiology and Ethnomedicine, August 2017
DOI 10.1186/s13002-017-0170-y
Pubmed ID
Authors

Martin Hitziger, Mónica Berger Gonzalez, Eduardo Gharzouzi, Daniela Ochaíta Santizo, Regina Solis Miranda, Andrea Isabel Aguilar Ferro, Ana Vides-Porras, Michael Heinrich, Peter Edwards, Pius Krütli

Abstract

Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 58 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 17 29%
Student > Bachelor 6 10%
Student > Master 6 10%
Student > Doctoral Student 5 9%
Student > Ph. D. Student 4 7%
Other 9 16%
Unknown 11 19%
Readers by discipline Count As %
Nursing and Health Professions 9 16%
Social Sciences 9 16%
Medicine and Dentistry 7 12%
Environmental Science 3 5%
Arts and Humanities 2 3%
Other 10 17%
Unknown 18 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 March 2018.
All research outputs
#3,889,862
of 14,550,524 outputs
Outputs from Journal of Ethnobiology and Ethnomedicine
#180
of 612 outputs
Outputs of similar age
#84,495
of 268,287 outputs
Outputs of similar age from Journal of Ethnobiology and Ethnomedicine
#2
of 5 outputs
Altmetric has tracked 14,550,524 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 612 research outputs from this source. They receive a mean Attention Score of 4.5. This one has gotten more attention than average, scoring higher than 68% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,287 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 5 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.