Bediako Shawn M, Harris Chey
University of Maryland, Baltimore County, Baltimore, MD, USA.
Morgan State University, Baltimore, MD, USA.
J Black Psychol. 2017 Oct;43(7):659-668. doi: 10.1177/0095798417696785. Epub 2017 Mar 1.
Sickle cell disease (SCD) is a genetic blood disorder that predominantly affects people of African descent. However, there is limited information on how social and cultural contexts affect SCD-related health care use. We explored whether communalism moderated the relation between racial centrality and emergency department use for SCD pain in a sample of 62 adults who were seen at a comprehensive clinic. Bivariate analyses showed a significant correlation between racial centrality and emergency department use ( = -.30, = .02). Pain-adjusted regression analyses indicated a moderating effect of communalism ( = .77, < .01) such that an inverse association between racial centrality and emergency department use was observed only at mean and low levels of communalism. Additional studies are needed to replicate these findings with larger samples. There is also a need for further studies that elucidate the role of culturally centered coping strategies on health care use in this patient group.
镰状细胞病（SCD）是一种主要影响非洲裔人群的遗传性血液疾病。然而，关于社会和文化背景如何影响与SCD相关的医疗保健使用的信息有限。我们在一个综合诊所就诊的62名成年人样本中，探讨了社群主义是否调节了种族中心性与因SCD疼痛而使用急诊科之间的关系。双变量分析显示种族中心性与急诊科使用之间存在显著相关性（r = -0.30，p = 0.02）。疼痛调整回归分析表明社群主义具有调节作用（β = 0.77，p < 0.01），即仅在社群主义平均水平和低水平时，才观察到种族中心性与急诊科使用之间存在负相关。需要进一步的研究以更大样本复制这些发现。还需要进一步的研究来阐明以文化为中心的应对策略在该患者群体医疗保健使用中的作用。
