Hong Hye Chong, Lee Hyeonkyeong, Collins Eileen G, Park Chang, Quinn Lauretta, Ferrans Carol Estwing
Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
BMC Womens Health. 2018 Jun 22;18(1):109. doi: 10.1186/s12905-018-0609-x.
Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women.
Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers.
Acculturation was positively related to trust in healthcare providers (β = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (β = -.60, p <. 001). Length of stay in the US was inversely related to distrust in the healthcare system (β = -.14, p <. 001), and discrimination in healthcare was positively related to distrust in the healthcare system (β = .60, p <. 001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001).
Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.
尽管信任在健康行为中起着重要作用,但从未有研究探讨过韩裔美国人(KA)对医疗服务提供者和医疗系统的信任度预测因素。本研究的目的是调查影响KA女性对医疗系统和医疗服务提供者信任的因素。
收集了196名KA女性的数据,研究在芝加哥大都市地区感知到的歧视和信任对乳腺癌筛查的影响。采用路径分析来确定影响对医疗系统和医疗服务提供者信任的因素。
文化适应与对医疗服务提供者的信任呈正相关(β = 0.15,p = 0.002),医疗系统中的歧视与对医疗服务提供者的信任呈负相关(β = -0.60,p < 0.001)。在美国的停留时间与对医疗系统的不信任呈负相关(β = -0.14,p < 0.001),医疗中的歧视与对医疗系统的不信任呈正相关(β = 0.60,p < 0.001)。对医疗服务提供者的信任与对医疗系统的不信任中度相关(r = 0.51,p < 0.001)。
较高的文化适应水平和较低的感知歧视水平被确定为对医疗服务提供者较高信任水平的预测因素。在美国停留时间较短和较高的歧视水平被确定为对医疗系统较高不信任水平的预测因素。感知到的歧视是增强对医疗系统信任的干预目标,从而减少KA人群中的医疗差距。