Song Lixin, Weaver Mark A, Chen Ronald C, Bensen Jeannette T, Fontham Elizabeth, Mohler James L, Mishel Merle, Godley Paul A, Sleath Betsy
School of Nursing, University of North Carolina, Chapel Hill, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
School of Medicine, University of North Carolina, Chapel Hill, USA.
Patient Educ Couns. 2014 Dec;97(3):339-46. doi: 10.1016/j.pec.2014.08.019. Epub 2014 Sep 4.
To examine the association between socio-cultural factors and patient-provider communication and related racial differences.
Data analysis included 1854 men with prostate cancer from a population-based study. Participants completed an assessment of communication variables, physician trust, perceived racism, religious beliefs, traditional health beliefs, and health literacy. A multi-group structural equation modeling approach was used to address the research aims.
Compared with African Americans, Caucasian Americans had significantly greater mean scores of interpersonal treatment (p<0.01), prostate cancer communication (p<0.001), and physician trust (p<0.001), but lower mean scores of religious beliefs, traditional health beliefs, and perceived racism (all p values <0.001). For both African and Caucasian Americans, better patient-provider communication was associated with more physician trust, less perceived racism, greater religious beliefs (all p-values <0.01), and at least high school education (p<0.05).
Socio-cultural factors are associated with patient-provider communication among men with cancer. No evidence supported associations differed by race.
To facilitate patient-provider communication during prostate cancer care, providers need to be aware of patient education levels, engage in behaviors that enhance trust, treat patients equally, respect religious beliefs, and reduce the difficulty level of the information.
研究社会文化因素与患者-医疗服务提供者沟通之间的关联以及相关的种族差异。
数据分析纳入了一项基于人群研究中的1854名前列腺癌男性患者。参与者完成了对沟通变量、对医生的信任、感知到的种族歧视、宗教信仰、传统健康观念和健康素养的评估。采用多组结构方程建模方法来实现研究目标。
与非裔美国人相比，美国白人在人际治疗（p<0.01）、前列腺癌沟通（p<0.001）和对医生的信任（p<0.001）方面的平均得分显著更高，但在宗教信仰、传统健康观念和感知到的种族歧视方面的平均得分更低（所有p值<0.001）。对于非裔美国人和美国白人而言，更好的患者-医疗服务提供者沟通都与更多的医生信任、更少的感知到的种族歧视、更强的宗教信仰（所有p值<0.01）以及至少高中教育程度相关（p<0.05）。
社会文化因素与癌症男性患者-医疗服务提供者的沟通有关。没有证据表明这种关联存在种族差异。
为了在前列腺癌护理期间促进患者-医疗服务提供者的沟通，医疗服务提供者需要了解患者的教育水平，采取增强信任的行为，平等对待患者，尊重宗教信仰，并降低信息的难度水平。
