Department of Psychology, Rutgers University, Camden, New Jersey, USA.
J Am Geriatr Soc. 2011 Dec;59(12):2356-62. doi: 10.1111/j.1532-5415.2011.03717.x. Epub 2011 Nov 8.
Language-related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). Using the 2007 California Health Interview Survey, the analytical sample included Latinos and APIs aged 55 and older (N = 2,960) who reported having seen a primary care provider within the past 2 years. Multivariable logistic regression was used to examine differences according to race or ethnicity and language concordance status (three groups: English-language concordant, other-language concordant, language discordant) in perceived mental health needs and discussion of those needs with a physician, adjusting for respondents' sociodemographic characteristics and mental health status. There were no significant differences in respondents' perceptions of their mental health needs across race or ethnicity or level of language concordance status (Ps > .41), although there were significant differences in whether respondents had discussed their mental health needs with their physicians according to participant race or ethnicity and language concordance status (adjusted odds ratio = 0.47, P = .04). Specifically, Spanish language-concordant Latinos were just as likely to discuss their mental health needs with their physicians as English language-concordant Latinos. In contrast, Asian language-concordant APIs were less likely to discuss their mental health needs with their physicians than English language-concordant APIs. There were no significant differences between language-discordant and English language-concordant older adults in predicting discussion of mental health concerns. These findings underscore the importance of overcoming language-related and cultural barriers to improve patient-provider discussions of older adults' mental health needs.
语言相关的医患沟通障碍可能会导致少数民族患者在精神卫生保健方面的种族和民族差异。因此，本研究旨在检验在老年拉丁裔、亚裔和太平洋岛民（API）中，感知的心理健康需求以及讨论这些需求是否会因种族或民族以及语言一致性而有所不同。使用 2007 年加利福尼亚健康访谈调查，分析样本包括在过去 2 年内报告看过初级保健提供者的 55 岁及以上的拉丁裔和 API（N=2960）。多变量逻辑回归用于检验根据种族或民族以及语言一致性状况（三组：英语一致、其他语言一致、语言不一致）感知心理健康需求以及与医生讨论这些需求的差异，调整受访者的社会人口特征和心理健康状况。根据种族或民族以及语言一致性状况，受访者对自身心理健康需求的看法没有差异（P>.41），尽管根据参与者的种族或民族以及语言一致性状况，受访者是否与医生讨论了自身的心理健康需求存在显著差异（调整后的优势比=0.47，P=.04）。具体来说，西班牙语一致的拉丁裔与英语一致的拉丁裔一样有可能与医生讨论他们的心理健康需求。相比之下，与英语一致的 API 相比，讲亚洲语言一致的 API 不太可能与医生讨论他们的心理健康需求。在预测讨论心理健康问题方面，语言不一致与英语一致的老年人之间没有显著差异。这些发现强调了克服语言相关和文化障碍以改善医患讨论老年人心理健康需求的重要性。
