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医疗服务提供者的沟通质量:患者体重和种族的影响。

Provider communication quality: influence of patients' weight and race.

作者信息

Wong Michelle S, Gudzune Kimberly A, Bleich Sara N

机构信息

Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, USA.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.

出版信息

Patient Educ Couns. 2015 Apr;98(4):492-8. doi: 10.1016/j.pec.2014.12.007. Epub 2015 Jan 7.

Abstract

OBJECTIVE

To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association.

METHODS

We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship.

RESULTS

Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04).

CONCLUSION

Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality.

PRACTICE IMPLICATION

Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients.

摘要

目的

研究患者体重与医疗服务提供者沟通质量之间的关系,并确定患者种族/族裔是否会改变这种关联。

方法

我们对2009 - 2010年医疗支出面板调查 - 家庭部分(N = 25,971)进行了横断面分析。我们的因变量是患者对医疗服务提供者解释清晰、倾听、表示尊重以及花费时间的报告。我们的自变量是患者体重状况和患者体重 - 种族/族裔分组。使用调查权重,我们进行了多因素逻辑回归,以检验患者体重与医患沟通指标之间的校正关联,以及患者种族/族裔是否会改变这种关系。

结果

与健康体重的白人相比,肥胖的黑人更不太可能报告其医疗服务提供者解释得好(比值比0.78;p = 0.02)或与他们共度足够时间(比值比0.81;p = 0.04),超重的黑人也更不太可能报告医疗服务提供者与他们共度足够时间(比值比0.78;p = 0.02)。健康体重的西班牙裔也更不太可能报告医疗服务提供者有充分的解释(比值比0.74;p = 0.04)。

结论

我们的研究提供了初步证据,表明超重/肥胖的黑人和健康体重的西班牙裔患者在医疗服务提供者沟通质量方面存在差异。

实践意义

关于体重偏见和文化能力的课程可能会改善医疗服务提供者与超重/肥胖的黑人和健康体重的西班牙裔患者之间的沟通。

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