认识SDG3研究人员:Mora Claramita

Mora Claramita是印度尼西亚Gadjah Mada大学医学和健康教育教育教授,也是一名全科医生。她的研究活动着重于建立有关健康提供者与亚洲患者之间关系的更多数据和观察,因为文化背景可能与西方社会大不相同。

Welcome to ourMeet the SDG3 researcherblog collection. We are interviewing a series of academics and practitioners working in diverse fields to achieve可持续发展目标3:确保健康的生活和促进健康all at all ages. You can find other posts in this collectionhere,,,,and discover what else Springer Nature is doing to advance progress towards achieving this goal on our dedicatedSDG3集线器


Please tell us a bit about yourself.

My name is Mora Claramita. I am a Professor and currently the Head of the Department of Medical and Health Professions Education at Universitas Gadjah Mada (UGM), and an active general practitioner at the UGM family doctor clinic.

我的研究generally focus on the relationship between doctor and patient, and health provider and patient. While most evidence of patient-centered care comes from western contexts, Indonesia and Asia are quite different in terms of the culture. The wide power distance and collectivist culture are opposite to the western individualistic culture (with more equity in the relationships between people) in terms of decision making.

The wide power distance affects the social hierarchical gap in the health professional-patient relationships and influences the one-way explanation from the doctor to the patient. For instance, the patient will likely respond with ‘yes’ while not being in actual agreement. Ultimately, the doctor may not obtain an accurate history of the patient’s illness, nor explore the patient’s perceptions of the illness. So when the data are incomplete, the diagnosis can be inaccurate, and consequently therapy may be ineffective. Moreover, decision making in collectivist cultures will be influenced by the family members. The doctors should be aware of limited patient’s contribution to the consultation, and still hold on patient’s autonomy in decision making and ‘do no harm’. Therefore, a two-way dialogue will be the key in approaching optimal health outcomes in hierarchical and collectivist cultures.

来自不同利益相关者的三位导师的讨论:Pak Andreas(NGO绵羊),Mora Claramita(UGM医学学院)和Mubarika Nugraheni(UGM文化学院),2008年

与Astrid Pratidina Susilo博士一起工作,我们的研究由震惊的受赠人(荷兰政府),U NPT Project U给U(Maastricht University at Maastricht University at MASITAS GADIAH MADA)和教育部(印度尼西亚共和国)。

Some of my career highlights include winning the 2019 Lyn Clearihan’Best Paper’ Award in亚太家庭医学杂志和2013-2014 Fulbright Senior Scholar Award, participating in the 2014 FAIMER Institute Philadelphia, and being Chair of Indonesian College of Health Professions Education.

How did you get into this research area?

My introduction to patient-centered care began with a role-play during my Master’s program in Maastricht University, the Netherlands. In one scenario, the simulated patient was out of town and unable to attend the next consultation. As the doctor, I was unaware of this information and continued a one-way communication without listening to the patient’s concerns. When she provided constructive feedback, I thought the one ability that was missed during my study to become a medical doctor was patient-centered communication skills. I was trained to obtain the patient history and conduct general physical examinations, but never to deal with the patient’s own concerns.

Left: Mora with Prof Cees and Prof Tri Nur Kristina. Center: with Prof Mark Graber. Right: with Prof Michael Kidd and Jillian Benson.

How does your work relate to SDG3?

相对于SDG3目标,我的研究的目的is to ensure that healthcare services are delivered effectively, in a patient-centered way, and consider the culture when communicating with patients. For example, the long course of tuberculosis (TB) treatments will require patient commitment and therefore, communication, cultural sensitivity and an understanding of the patient’s background will be key factors for an optimum healing process.

Mora at the UGM clinic with colleagues.

印度尼西亚为结核病患者提供免费服务和药物治疗,但排名为2nd世界结核病发病率最高。患者不能仅仅被诊断出来,并为结核病提供药物。应仔细认可并应对患者的担忧。通过齐头并进,健康提供者可以在患者及其家人的帮助下解决这些问题,以实现结核病治疗。如果我们希望消除结核病,应对污名,漫长的药物病程的影响,并发症的风险以及经济负担进行良好的传播和讨论。The impact of dialogue in the communication between patients and health providers does play a role in achieving the SDG3 target – specifically target 3.3: ‘By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.’

您领域中最紧迫的研究问题和/或您对未来进步的希望是什么?

The hierarchical culture – the social gap between the doctor and the patient – is the primary challenge towards effective communication that supports an alliance between doctor and patient. Active listening is the most basic yet most promising communication skill training within this cultural context. On top of that, in primary care, patients should be scheduled for appointments to ensure proper communication.

研究人员应探索更多与世界东南部地区的患者进行更多伙伴关系沟通的情况。越来越多的研究人员和从业人员应该在这一领域进行更深入的研究,从而对人们的健康产生了很大的影响。

Please describe hurdles you’ve come across during your career.

When I graduated as a medical doctor and working at a university clinic, I did not dream to continue my professional practice in this clinic, and of course as many other young graduates, I would continue to be a specialist in a hospital. However, few opportunities to learn ‘communication skills’ (through role-play, practice, feedback) always stimulated me to learn better. And (it is also a big surprise for me) while doing research I kept on my practice until today. Apparently the ‘communication skills’ subject has been bridging my professional practice and health professions education that I study. It’s a blessing in disguise. And I also joined a national development on family medicine specialist program, a new specialization in Indonesia, that also requires lots of communication skills training.

Left: group photo with Prof Michael Kidd in 2016 at Flinders University, Australia. Right: group photo at a conference in 2017.

就障碍而言 - 在一个持有等级文化和间接对话方式的社会中,很难向医学专家解释我一直在研究(沟通技巧)的社会。因此,当我向医疗居民提供沟通技巧培训时,教师委员会更喜欢其他社会研究专家。但是,没有专业医疗保健专业背景的培训师可能无法对医疗诊断和治疗以及与沟通技巧的关系有深入的观点。因此,通常首选有关礼貌礼节的培训。

Please tell us about a resource or person that has particularly inspired you?

与患者沟通的技能’由Silverman等人,2016年是我读的第一本书,每当我发表文章时,它一直是我的主要参考文献。我的研究还基于霍夫斯泰德(Hofstede)的文化维度框架,2010年“文化和组织’。

在我整个职业生涯中,一些特殊的影响力和导师是Cees Van der Vleutnen教授和Jan van Dalen博士(我的博士主管),爱荷华大学的硕士学位论文主管Gerard Majoor博士(我的硕士学位主管)和Mark Alan Graber教授。


您可以在此集合中找到其他帖子here.

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