Gaston Gina B
a Jane Addams College of Social Work , University of Illinois , Chicago , IL , USA.
AIDS Care. 2013;25(9):1159-65. doi: 10.1080/09540121.2012.752783. Epub 2013 Jan 29.
Most studies of cultural competence in healthcare examine healthcare providers' definitions of cultural competence practices. This study is unique in that it examines the relationship between African-American patients' perceptions of the cultural competence of their HIV healthcare providers and the adherence of these patients to medical self-care and antiretroviral therapy (ART). This cross-sectional, exploratory, descriptive study was conducted at the Ruth Rothstein CORE Center in Chicago, Illinois. The sample consisted of 202 HIV-positive African-Americans who completed surveys during clinic visits. Multiple measures were used, including the Patient Assessments of Cultural Competency survey instrument developed by the Department of Health and Human Services Agency for Healthcare Research and Quality. Medical self-care was measured using the advice and instructions scale and the self-care symptom management for people living with HIV/AIDS categorical scale. ART adherence was measured using the Adherence Behaviors Self-Report and Adherence Self-Report scales. The data revealed many significant correlations between variables. The more patients believed that providers should integrate culture in HIV treatment; the better their reported health (F1,138=0.151, P=0.05) and the more they followed their provider's advice and instructions (medical self-care; F1,138=0.029, P=0.05). Participants who trusted their providers engaged in more medical self-care (F1,138=0.280, P=0.01). More shared treatment decisions were reported among participants who had higher levels of education (F1,127=0.337, P=0.05). Findings of this study indicate the need for increased attention to the role of cultural competence in HIV/AIDS care. Understanding patient perceptions of provider cultural competence has the potential to improve HIV treatment adherence and health outcomes.
大多数关于医疗保健领域文化能力的研究都在考察医疗保健提供者对文化能力实践的定义。本研究的独特之处在于，它考察了非裔美国患者对其艾滋病毒医疗保健提供者文化能力的认知与这些患者坚持医疗自我护理和抗逆转录病毒疗法（ART）之间的关系。这项横断面、探索性、描述性研究是在伊利诺伊州芝加哥的露丝·罗斯坦核心中心进行的。样本包括202名艾滋病毒呈阳性的非裔美国人，他们在门诊就诊时完成了调查。使用了多种测量方法，包括美国卫生与公众服务部医疗保健研究与质量局开发的患者文化能力评估调查问卷。医疗自我护理通过建议和指导量表以及艾滋病毒/艾滋病感染者自我护理症状管理分类量表来衡量。ART依从性通过依从行为自我报告量表和依从自我报告量表来衡量。数据显示变量之间存在许多显著相关性。患者越认为提供者应将文化融入艾滋病毒治疗；他们报告的健康状况就越好（F1,138 = 0.151，P = 0.05），并且他们越遵循提供者的建议和指导（医疗自我护理；F1,138 = 0.029，P = 0.05）。信任其提供者的参与者进行了更多的医疗自我护理（F1,138 = 0.280，P = 0.01）。在教育水平较高的参与者中，报告的共同治疗决策更多（F1,127 = 0.337，P = 0.05）。本研究的结果表明，需要更加关注文化能力在艾滋病毒/艾滋病护理中的作用。了解患者对提供者文化能力的认知有可能提高艾滋病毒治疗的依从性和健康结果。
