Pollak Kathryn I, Arredondo Elva M, Yarnall Kimberly S H, Lipkus Isaac, Myers Evan, McNeilly Maya, Costanzo Philip
Duke Comprehensive Cancer Center, Cancer Prevention, Detection and Control Research Program, Duke University, Durham, North Carolina 27710-2949, USA.
Ethn Dis. 2002 Fall;12(4):578-85.
This study examined racial differences in primary care residents' rates of addressing smoking cessation. We expected residents to have higher rates of addressing cessation with White female patients as compared with African-American or Hispanic female patients, due, in part, to residents having higher outcome expectancies, self-efficacy, lower barriers, and less reliance on stereotypes. Residents (N = 90) were an average of 31 years old; two-thirds were White internal medicine residents. Residents viewed a video of a lower-middle class White, African-American, or Hispanic female interacting with her physician about stomach pain. Results indicate that residents were very likely to address smoking cessation, regardless of patients' race. Compared to residents assigned to an ethnic minority patient, residents assigned to the White patient were less likely to believe the patient would follow their advice (P < .03) and also perceived more barriers to address smoking cessation (P < .04). Reliance on the stereotype of Whites mediated the racial difference in outcome expectancies. Implications are that residents may be relying on stereotypes when they assess lower-middle class White female patients' receptivity to smoking cessation advice. Future research on the role of stereotyping in medical settings is warranted.
本研究调查了初级保健住院医师在处理戒烟问题上的种族差异。我们预计，与非裔美国女性或西班牙裔女性患者相比，住院医师对白人女性患者处理戒烟问题的比例会更高，部分原因在于住院医师对白人女性患者有更高的结果预期、自我效能感，面临的障碍更低，且较少依赖刻板印象。住院医师（N = 90）平均年龄为31岁；三分之二是白人内科住院医师。住院医师观看了一段视频，视频内容是一名中下层阶级的白人、非裔美国或西班牙裔女性与她的医生讨论胃痛问题。结果表明，无论患者种族如何，住院医师都很有可能处理戒烟问题。与被分配处理少数族裔患者问题的住院医师相比，被分配处理白人患者问题的住院医师不太相信患者会听从他们的建议（P < .03），并且也认为处理戒烟问题存在更多障碍（P < .04）。对白人刻板印象的依赖调节了结果预期中的种族差异。这意味着住院医师在评估中下层阶级白人女性患者对戒烟建议的接受程度时，可能依赖了刻板印象。有必要对刻板印象在医疗环境中的作用进行进一步研究。
