A community-university collaborative partnership assessed self-reported work-related health effects and environmental factors in Boston's Vietnamese immigrant community via an interviewer-assisted survey. Seventy-one nail technicians responded. Musculoskeletal disorders, skin problems, respiratory irritation and headaches were commonly reported as work-related, as were poor air quality, dusts and offensive odors. The reporting of a work-related respiratory symptom was significantly associated with the reporting of exposure factors such as poorer air quality. Absence of skin disorders was associated with glove use and musculoskeletal symptoms were associated with years worked as a nail technician. Work-related health effects may be common in nail salon work. Chemical and musculoskeletal hazards should be reduced through product and equipment redesign.

No abstract

This article examines the doctor’s elicitation of the patient’s presenting health concern in two clinical settings in the Vietnamese public hospital system: the consulting room and the ward. The data were taken from 66 audio-recorded consultations. Our analysis shows that the elicitors used by the doctor in the consulting room often communicate a weak epistemic stance towards the patient’s health issue, while those used in the ward tend to signal a strong epistemic stance. In addition, this contrast between the elicitors employed in the consulting room and the ward is evident in our data regardless of whether the consultation is a first visit or a same follow-up (in which the doctor is the same one that treated the patient on their last visit), though the contrast is less clear for different follow-ups (in which the doctor has not treated the patient before). An additional finding is that the clinical setting has some bearing on the use of inappropriate elicitation formats (in which the doctor opens the visit with an elicitor which is more appropriate for another type of visit). The precise way in which each of the consulting room and the ward operates is, of course, a feature of the Vietnamese public hospital system itself. Hence, the overall contrast between the elicitors and elicitation formats used in these two settings illustrates how, on a more general level, the institutional context can have an impact on doctor-patient communication.

AbstractThis study is concerned with the practice of invoking third parties among doctors and patients in Vietnamese medical consultations. These third parties are relatives of the patient who are also medical professionals. We show that doctors invoke relatives-plus-medical professionals in order to elicit information from patients, while patients adopt this practice in order to circumvent a troublesome administrative requirement; obtain a preferred form of treatment; receive a health-related service from the hospital, while also diminishing accountability for making this request in case it turns out to be irregular; give reasons for selecting the current hospital; or challenge the doctor's expertise. Another possible motive is to receive special attention from the treating doctor. We suggest that doctors and patients are particularly inclined to invoke relatives-plus-medical professionals as third parties because of two social forces within Vietnamese culture: collectivism and social status. We also adduce evidence that, as a determinant of the patient's future treatment for their problem, their familial relationship with the third party overrides this person's status as a medical professional in this cultural context. More broadly, our findings indicate that medical communication is not invariant across cultures, but can be shaped by culture-specific forces.