Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.
Patient Educ Couns. 2020 Sep;103(9):1736-1744. doi: 10.1016/j.pec.2020.03.019. Epub 2020 Mar 20.
In a previous study of patients newly enrolled in HIV care, we observed that clinicians were less likely to address emotional issues expressed by African-American patients compared to whites. We sought to verify and expand these findings in a larger group of patients established in HIV care.
We used VR-CoDES to analyze transcripts from 342 audio-recorded medical visits in the United States. We used random intercept multilevel logistic regression to assess associations between patient and clinician characteristics and patterns of emotional talk.
African-American patients were less likely than others to spontaneously express emotions (OR 0.50; 95 % CI 0.29-0.85). Clinicians, who were predominantly white, were more likely to respond to emotional expressions by African-American patients explicitly (OR 1.56; 95 % CI 1.11-2.20) but less likely to offer neutral/passive responses that provide space for emotional conversation (OR 0.56; 95 % CI 0.37-0.84) and more likely to block discussion of the emotional issue (OR 2.20; 95 % CI 1.05-4.63). Emotional talk did not vary by patient age or gender.
These results confirm our prior findings, demonstrating less open emotional communication between African-American patients and their providers.
Addressing racial differences in communicating about emotions may reduce disparities in patient-clinician relationships.
在一项对新入艾滋病毒护理的患者的研究中，我们观察到临床医生与非裔美国患者相比，较少关注他们表达的情绪问题。我们试图在更大的艾滋病毒护理患者群体中验证并扩展这些发现。
我们使用 VR-CoDES 分析了美国 342 次音频记录的医疗就诊的转录本。我们使用随机截距多水平逻辑回归来评估患者和临床医生特征与情感表达模式之间的关联。
与其他人相比，非裔美国患者更不可能自发地表达情感（OR 0.50；95%置信区间 0.29-0.85）。临床医生主要是白人，他们更有可能明确回应非裔美国患者的情感表达（OR 1.56；95%置信区间 1.11-2.20），但不太可能提供中性/被动的反应来为情感对话留出空间（OR 0.56；95%置信区间 0.37-0.84），并且更有可能阻止讨论情感问题（OR 2.20；95%置信区间 1.05-4.63）。情感表达与患者的年龄或性别无关。
这些结果证实了我们之前的发现，表明非裔美国患者与他们的提供者之间的情感沟通不够开放。
解决沟通情感方面的种族差异可能会减少医患关系中的差异。
