OBJECTIVE The field of cultural neuropsychology has grown exponentially over the last three decades. With a limited culturally informed evidence base to guide neuropsychological practice, the acceptability of existing paradigms has been called into question when applied to culturally diverse and educationally disadvantaged groups. This qualitative study aimed to explore the experiences of Greek Australian older adults who underwent a cognitive assessment to better understand potential barriers and facilitators to engagement and to improve neuropsychological assessment outcomes. METHOD Semi-structured interviews were developed to explore cultural attitudes and contextual factors relating to neuropsychological assessment. Interviews were conducted by Greek-speaking neuropsychologists using a sample of 10 healthy elderly Greek Australians following the completion of a comprehensive neuropsychological assessment. Data were analyzed using a phenomenological design within a critical realist framework. RESULTS Analysis revealed the emergence of three broad themes: sociocultural factors, experiences within the broader medical system, and the assessment experience. Engagement with cognitive assessment was influenced by several factors, including rapport building, understanding of the assessment, and use of inappropriate tests. Furthermore, level and quality of education, sex differences, language barriers, acculturation, previous experiences of prejudice, anxiety, and a preference for Greek-speaking clinicians were additional factors reported to affect the client experience and validity of assessment outcomes. CONCLUSION Neuropsychological assessment is, in part, affected by culturally reinforced attitudes. Failing to adjust the relationship between the clinician and client, test environment, style of communication, and the use of culturally inappropriate tests is likely to affect the validity of assessment outcomes.

中文翻译：

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探索社会文化因素如何影响老年希腊裔澳大利亚人完成神经心理学评估的体验。

目标 文化神经心理学领域在过去三十年中呈指数增长。由于指导神经心理学实践的文化证据基础有限，现有范式在应用于文化多样性和教育弱势群体时的可接受性受到质疑。这项定性研究旨在探索接受认知评估的希腊澳大利亚老年人的经历，以更好地了解参与的潜在障碍和促进因素，并改善神经心理学评估结果。方法 半结构化访谈的目的是探索与神经心理学评估相关的文化态度和背景因素。希腊语神经心理学家在完成全面的神经心理学评估后，对 10 名健康的希腊裔澳大利亚老年人进行了访谈。在批判现实主义框架内使用现象学设计来分析数据。结果分析揭示了三大主题的出现：社会文化因素、更广泛的医疗系统内的经验以及评估经验。参与认知评估受到多种因素的影响，包括建立融洽关系、对评估的理解以及使用不适当的测试。此外，教育水平和质量、性别差异、语言障碍、文化适应、以前的偏见经历、焦虑、据报道，对讲希腊语的临床医生的偏好是影响客户体验和评估结果有效性的其他因素。结论 神经心理学评估部分受到文化强化态度的影响。未能调整临床医生与客户之间的关系、测试环境、沟通方式以及使用文化上不适当的测试可能会影响评估结果的有效性。