Cervantes-Ortega Maribel, Du Senxi, Biegler Kelly A, Al-Majid Sadeeka, Davis Katelyn C, Chen Yunan, Kobsa Alfred, Mukamel Dana B, Sorkin Dara H
Department of Epidemiology, University of California Irvine, Irvine, USA.
Keck School of Medicine, University of Southern California, Los Angeles, USA.
Int J Healthc. 2020;6(2):35-43. doi: 10.5430/ijh.v6n2p35. Epub 2020 May 6.
Despite declining cancer incidence and mortality rates, Latina patients continue to have lower 5-year survival rates compared to their non-Hispanic white counterparts. Much of this difference has been attributed to lack of healthcare access and poorer quality of care. Research, however, has not considered the unique healthcare experiences of Latina patients.
Latina women with prior diagnoses of stage 0-III breast cancer were asked to complete a cross-sectional survey assessing several socio-demographic factors along with their experiences as cancer patients. Using a series of linear regression models in a sample of 68 Mexican-American breast cancer survivors, we examined the extent to which patients' ratings of provider interpersonal quality of care were associated with patients' overall healthcare quality, and how these associations varied by acculturation status.
Findings for Latina women indicated that both participatory decision-making (PDM) ( = 0.62, < .0001) and trust ( = 0.53, = .02) were significantly associated with patients' ratings of healthcare quality. The interaction between acculturation and PDM further suggested that participating in the decision-making process mattered more for less acculturated than for more acculturated patients ( = -0.51, .01).
The variation across low and high acculturated Latinas in their decision-making process introduces a unique challenge to health care providers. Further understanding the relationship between provider-patient experiences and ratings of overall healthcare quality is critical for ultimately improving health outcomes.
尽管癌症发病率和死亡率在下降，但与非西班牙裔白人患者相比，拉丁裔患者的5年生存率仍然较低。这种差异很大程度上归因于缺乏医疗保健机会和较差的医疗质量。然而，研究尚未考虑拉丁裔患者独特的医疗保健经历。
对先前诊断为0-III期乳腺癌的拉丁裔女性进行横断面调查，评估几个社会人口学因素以及她们作为癌症患者的经历。在68名墨西哥裔美国乳腺癌幸存者的样本中使用一系列线性回归模型，我们研究了患者对医疗服务提供者人际护理质量的评分与患者整体医疗质量之间的关联程度，以及这些关联如何因文化适应状态而异。
拉丁裔女性的研究结果表明，参与式决策（PDM）（= 0.62，< .0001）和信任（= 0.53，= .02）均与患者对医疗质量的评分显著相关。文化适应与PDM之间的相互作用进一步表明，参与决策过程对文化适应程度较低的患者比对文化适应程度较高的患者更为重要（= -0.51，.01）。
文化适应程度低和高的拉丁裔女性在决策过程中的差异给医疗服务提供者带来了独特的挑战。进一步了解医患体验与整体医疗质量评分之间的关系对于最终改善健康结果至关重要。
