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在信任医生方面,哪些因素至关重要:种族/族裔、社会人口统计学因素,还是获得医疗保健的机会及就医体验?

What Matters When It Comes to Trust in One's Physician: Race/Ethnicity, Sociodemographic Factors, and/or Access to and Experiences with Health Care?

作者信息

Nguyen Anthony L, Schwei Rebecca J, Zhao Ying-Qi, Rathouz Paul J, Jacobs Elizabeth A

机构信息

Division of Hematology and Medical Oncology, Loma Linda University Health, Loma Linda, California, USA.

BerbeeWalsh Department of Emergency Medicine, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA.

出版信息

Health Equity. 2020 Jun 29;4(1):280-289. doi: 10.1089/heq.2019.0101. eCollection 2020.

Abstract

Interpersonal trust is linked to therapeutic factors of patient care, including adherence to treatment, continuity with a provider, perceived effectiveness of care, and clinical outcomes. Differences in interpersonal trust across groups may contribute to health disparities. We explored whether differences in interpersonal trust varied across three racial/ethnic groups. Additionally, we explored how different health care factors were associated with differences in trust. We conducted a cross-sectional, computer-administered survey with 600 racially and ethnically diverse adults in Chicago, IL, from a wide variety of neighborhoods. We used staged ordinal logistic regression models to analyze the association between interpersonal trust and variables of interest. Interpersonal trust did not differ by racial or ethnic group. However, individuals with 0-2 annual doctor visits, those reporting having a "hard time" getting health care services, those answering "yes" to "Did you not follow advice or treatment plan because it cost too much?," and those reporting waiting more than 6 days/never getting an appointment had significantly increased odds of low trust. We did not find differences across racial/ethnic groups. Our study suggests that access to health care and interactions within the health care setting negatively impact individual's trust in their physician.

摘要

人际信任与患者护理的治疗因素相关,包括对治疗的依从性、与医疗服务提供者的连续性、感知到的护理效果以及临床结果。不同群体之间人际信任的差异可能导致健康差距。我们探讨了人际信任的差异在三个种族/族裔群体中是否存在变化。此外,我们还探讨了不同的医疗保健因素如何与信任差异相关联。我们在伊利诺伊州芝加哥市对来自不同社区的600名种族和族裔各异的成年人进行了一项横断面的计算机管理调查。我们使用分层有序逻辑回归模型来分析人际信任与感兴趣变量之间的关联。人际信任在种族或族裔群体之间没有差异。然而,每年看医生次数为0至2次的人、报告在获得医疗保健服务方面“有困难”的人、对“你是否因为费用太高而没有遵循建议或治疗计划?”回答“是”的人,以及报告等待超过6天/从未预约到的人,其信任度低的几率显著增加。我们没有发现种族/族裔群体之间存在差异。我们的研究表明,获得医疗保健的机会以及在医疗保健环境中的互动会对个人对其医生的信任产生负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8e1/8175262/c5ecee51418d/heq.2019.0101_figure1.jpg

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