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寻求成瘾治疗的黑人患者群体中基于群体的医疗不信任和护理期望。

Group-based medical mistrust and care expectations among black patients seeking addiction treatment.

作者信息

Hall O Trent, Bhadra-Heintz Nia M, Teater Julie, Samiec Jennifer, Moreno Jose, Dixon-Shambley Kamilah, Rood Kara M, Fiellin David A, Jordan Ayana

机构信息

Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Talbot Hall 181 Taylor Ave., Columbus, OH 43203, USA.

College of Medicine, The Ohio State University, Columbus, OH, USA.

出版信息

Drug Alcohol Depend Rep. 2022 Jan 18;2:100026. doi: 10.1016/j.dadr.2022.100026. eCollection 2022 Mar.

Abstract

BACKGROUND

Black patients seeking addiction care experience poorer treatment access, retention, and outcomes when compared to White counterparts. Black patients may have elevated group-based medical mistrust, which has been associated with poorer health outcomes and increased experiences of racism across multiple healthcare contexts. The relationship between group-based medical mistrust and expectations for addiction treatment among Black individuals remains untested.

METHODS

A total of 143 Black participants were recruited from two addiction treatment centers in Columbus, Ohio. Participants completed the Group Based Medical Mistrust Scale (GBMMS) and answered questions related to expectations of addiction treatment. Descriptive analysis and Spearman's rho correlations were performed to assess for relationships between group-based medical mistrust and expectations of care.

RESULTS

Group-based medical mistrust in Black patients was associated with self-reported delay in accessing addiction treatment, anticipation of racism during addiction treatment, non-adherence and discrimination-precipitated relapse. However, non-adherence to treatment was least strongly correlated with group-based medical mistrust demonstrating an opportunity for engagement.

CONCLUSION

Group-based medical mistrust is associated with Black patients' care expectations when seeking addiction treatment. Use of the GBMMS within addiction medicine to address themes of mistrust in patients, and potential biases in providers, may improve treatment access and outcomes.

摘要

背景

与白人患者相比,寻求成瘾治疗的黑人患者在治疗可及性、治疗保留率和治疗结果方面较差。黑人患者可能存在较高的基于群体的医疗不信任感,这与较差的健康结果以及在多个医疗环境中增加的种族主义经历有关。基于群体的医疗不信任与黑人个体对成瘾治疗的期望之间的关系仍未得到检验。

方法

从俄亥俄州哥伦布市的两个成瘾治疗中心招募了总共143名黑人参与者。参与者完成了基于群体的医疗不信任量表(GBMMS),并回答了与成瘾治疗期望相关的问题。进行描述性分析和斯皮尔曼等级相关分析,以评估基于群体的医疗不信任与护理期望之间的关系。

结果

黑人患者中基于群体的医疗不信任与自我报告的成瘾治疗延迟、成瘾治疗期间对种族主义的预期、不依从和歧视导致的复发有关。然而,不依从治疗与基于群体的医疗不信任的相关性最弱,这表明存在参与的机会。

结论

基于群体的医疗不信任与黑人患者寻求成瘾治疗时的护理期望有关。在成瘾医学中使用GBMMS来解决患者的不信任主题以及提供者的潜在偏见,可能会改善治疗可及性和治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0516/9949334/d3f60504de18/gr1.jpg

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