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拉丁裔移民医疗保健歧视相关因素考察:医疗保健关系与语言的作用

An Examination of Factors Associated with Healthcare Discrimination in Latina Immigrants: The Role of Healthcare Relationships and Language.

作者信息

Sheppard Vanessa B, Williams Karen Patricia, Wang Judy, Shavers Vickie, Mandelblatt Jeanne S

出版信息

J Natl Med Assoc. 2014 Summer;106(1):15-22. doi: 10.1016/S0027-9684(15)30066-3.

Abstract

ACKNOWLEDGEMENT

The authors are grateful to all of the women who took time to participate in the study, Dr. Elmer Huerta and members of the Latin American Cancer Research Coalition. Funding for these activities were supported, in part, by ACS grants MRSGT-06-132-01-CPPB (VBS), Herbert W. Nickens, M.D., Junior Faculty Achievement Award, AAMC (VBS), and MRSGT-05-104-01-CPPB (JW), National Cancer Institute grants UO1 CA86114 (EH, JM), U01-CA114593 (JM), and KO5 CA96940 (JM).

BACKGROUND

Understanding factors that are associated with perceived discrimination in Latina immigrants may provide opportunities to improve care for this growing population.

OBJECTIVE

To examine the prevalence of discrimination experiences in urban Latina immigrants and identify socio-cultural and healthcare factors that predict discrimination experiences.

DESIGN

Cross-sectional survey of 166 Latina immigrants.

MEASUREMENTS

Socio-cultural: region of origin, primary language, and education. Healthcare factors: insurance, place of care, patient-provider communication, trust in provider, and satisfaction with care. Multivariable logistic regression was used to examine factors that predicted discrimination.

RESULTS

42% had at least one discrimination experience. Communication with providers was the factor most strongly associated with reporting having a discrimination experience while controlling for other variables (p < 01). Women with good communication with their provider were 71% less likely to report discrimination.

CONCLUSION

Better communication with providers may reduce Latinas' perceptions of discrimination and thereby improve healthcare access and use of services.

摘要

致谢

作者们感谢所有抽出时间参与本研究的女性,以及埃尔默·韦尔塔博士和拉丁美洲癌症研究联盟的成员。这些活动的资金部分得到了美国癌症协会的资助,包括MRSGT - 06 - 132 - 01 - CPPB(VBS)、赫伯特·W·尼肯斯医学博士初级教员成就奖(美国医学协会,VBS)以及MRSGT - 05 - 104 - 01 - CPPB(JW);美国国立癌症研究所的资助包括UO1 CA86114(EH,JM)、U01 - CA114593(JM)以及KO5 CA96940(JM)。

背景

了解与拉丁裔移民中感知到的歧视相关的因素,可能为改善对这一不断增长的人群的护理提供机会。

目的

研究城市拉丁裔移民中歧视经历的患病率,并确定预测歧视经历的社会文化和医疗保健因素。

设计

对166名拉丁裔移民进行横断面调查。

测量

社会文化因素:原籍地区、主要语言和教育程度。医疗保健因素:保险、就医地点、医患沟通、对医疗服务提供者的信任以及对护理的满意度。使用多变量逻辑回归来研究预测歧视的因素。

结果

42%的人至少有过一次歧视经历。在控制其他变量的情况下,与医疗服务提供者的沟通是与报告有歧视经历最密切相关的因素(p < 0.01)。与医疗服务提供者沟通良好的女性报告有歧视的可能性降低71%。

结论

与医疗服务提供者进行更好的沟通可能会减少拉丁裔女性对歧视的感知,从而改善医疗保健服务的可及性和服务利用情况。

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