University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.
University of Massachusetts Boston (UMB), Boston, MA, 02125, USA.
AIDS Behav. 2022 May;26(5):1422-1430. doi: 10.1007/s10461-021-03496-2. Epub 2021 Oct 12.
In this mixed-methods study, we examine the relationship between provider communication and patient health literacy on HIV continuum of care outcomes among women living with HIV in the United States. We thematically coded qualitative data from focus groups and interviews (N = 92) and conducted mediation analyses with quantitative survey data (N = 1455) collected from Women's Interagency HIV Study participants. Four qualitative themes related to provider communication emerged: importance of respect and non-verbal cues; providers' expressions of condescension and judgement; patient health literacy; and unclear, insufficient provider communication resulting in diminished trust. Quantitative mediation analyses suggest that higher health literacy is associated with higher perceived patient-provider interaction quality, which in turn is associated with higher levels of trust in HIV providers, improved antiretroviral medication adherence, and reduced missed clinical visits. Findings indicate that enhancing provider communication and bolstering patient health literacy could have a positive impact on the HIV continuum of care.
在这项混合方法研究中，我们研究了美国艾滋病毒感染者护理连续体结果中提供者沟通和患者健康素养之间的关系。我们对焦点小组和访谈（N=92）的定性数据进行了主题编码，并对来自妇女机构间艾滋病毒研究参与者的定量调查数据（N=1455）进行了中介分析。与提供者沟通相关的四个定性主题出现：尊重和非言语暗示的重要性；提供者表现出的屈尊和判断；患者健康素养；以及沟通不清晰、不充分导致信任度降低。定量中介分析表明，较高的健康素养与较高的感知患者-提供者互动质量相关，而较高的互动质量又与对艾滋病毒提供者的更高信任度、更好的抗逆转录病毒药物依从性和减少错过临床就诊相关。研究结果表明，增强提供者沟通和提高患者健康素养可能对艾滋病毒护理连续体产生积极影响。
