Guadagnolo B Ashleigh, Cina Kristin, Helbig Petra, Molloy Kevin, Reiner Mary, Cook E Francis, Petereit Daniel G
Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
J Health Care Poor Underserved. 2009 Feb;20(1):210-26. doi: 10.1353/hpu.0.0108.
To assess barriers to cancer care among Native Americans, whose health outcomes compare unfavorably with those of the general U.S. population.
We undertook a comparative community-based participatory research project in which newly-diagnosed cancer patients were prospectively surveyed using novel scales for medical mistrust and satisfaction with health care. Socio-demographic information was obtained. Mean scale scores for mistrust and satisfaction were analyzed by race. Multivariable models were used to adjust for income, education level, and distance lived from cancer care institute.
Participation refusal rate was 38%. Of 165 eligible patients, 52 were Native American and 113 where non-Hispanic White. Native Americans expressed significantly higher levels of mistrust (p=0001) and lower levels of satisfaction (p=.0001) with health care than Whites. In multivariable analyses, race was the only factor found to be significantly predictive of higher mistrust and lower satisfaction scores.
Native Americans exhibit higher medical mistrust and lower satisfaction with health care.
评估美国原住民在癌症护理方面面临的障碍，他们的健康状况与美国普通人群相比处于劣势。
我们开展了一项基于社区的比较性参与式研究项目，使用新的医疗不信任和医疗保健满意度量表对新诊断的癌症患者进行前瞻性调查。获取了社会人口学信息。按种族分析不信任和满意度的平均量表得分。使用多变量模型对收入、教育水平和居住地与癌症护理机构的距离进行调整。
参与拒绝率为38%。在165名符合条件的患者中，52名是美国原住民，113名是非西班牙裔白人。与白人相比，美国原住民对医疗保健表现出更高的不信任程度（p = 0.001）和更低的满意度（p = 0.0001）。在多变量分析中，种族是唯一被发现能显著预测更高不信任度和更低满意度得分的因素。
美国原住民对医疗保健表现出更高的不信任和更低的满意度。
