Haywood Carlton, Bediako Shawn, Lanzkron Sophie, Diener-West Marie, Strouse John, Haythornthwaite Jennifer, Onojobi Gladys, Beach Mary Catherine
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, USA.
Department of Psychology, The University of Maryland, Baltimore County, Baltimore, MD 21205, USA.
Patient Educ Couns. 2014 Aug;96(2):159-64. doi: 10.1016/j.pec.2014.05.013. Epub 2014 May 23.
To assess disparities in the quality of healthcare provider communication experienced by African-American adults with and without sickle cell disease (SCD) in the U.S.
Poor provider communication was assessed by the Provider Communication subscale of the Consumer Assessment of Healthcare Plans and Systems survey. The SCD sample was obtained from participants in a multicenter observational study of healthcare experiences. The national African-American sample data was obtained from published national estimates.
The SCD sample was more likely than the national sample to report poor communication in 3 out of 4 communication domains: listening (22.3% vs. 11.5%, p<0.0001); showing respect (26.1% vs. 9.5%, p<0.0001); and spending enough time (38.3% vs. 16.2%, p<0.0001). Differences were consistent in young, but not old, patients and showed some variation by self-reported health status and education.
The communication difficulties experienced by persons with SCD do not appear reducible to their predominantly African-American race, but may result from more disease-specific factors.
Healthcare providers should take particular care in recognizing and demonstrating recommended communication skills with SCD patients as these patients may be particularly vulnerable to, and cognizant of, poor quality interactions.
评估美国患有和未患有镰状细胞病（SCD）的非裔美国成年人在医疗服务提供者沟通质量方面的差异。
通过医疗保健计划和系统消费者评估调查中的提供者沟通子量表来评估提供者沟通不佳的情况。SCD样本来自一项多中心医疗保健体验观察性研究的参与者。全国非裔美国样本数据来自已发表的全国估计数。
在四个沟通领域中的三个领域，SCD样本比全国样本更有可能报告沟通不佳：倾听（22.3%对11.5%，p<0.0001）；表示尊重（26.1%对9.5%，p<0.0001）；以及花费足够时间（38.3%对16.2%，p<0.0001）。差异在年轻患者中一致，但在老年患者中不一致，并且根据自我报告的健康状况和教育程度存在一些差异。
SCD患者经历的沟通困难似乎不能归因于他们主要是非裔美国人的种族，而可能是由更多与疾病相关的因素导致的。
医疗服务提供者在识别和向SCD患者展示推荐的沟通技巧时应格外小心，因为这些患者可能特别容易受到质量差的互动的影响，并且也会意识到这一点。
