Culture and the care of children with chronic conditions. Their physicians' views

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.