Garcia Diana Martinez, Pinzon Maria Mora, Perales-Puchalt Jaime
Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
Department of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
medRxiv. 2024 Dec 12:2024.12.06.24318619. doi: 10.1101/2024.12.06.24318619.
Alzheimer's Disease and Related dementias (ADRD) are disproportionately underdiagnosed, misdiagnosed, and undertreated in Latino/a/e/x populations living in the U.S. Latino/a/e/x families also experience low access to ADRD caregiver support services and high levels of depression. Primary care providers (PCPs) are the first point of contact for patients and their families, and they are critical in understanding the factors associated with disparities in accessing services. This project aims to reflect on the barriers that Latino/a/e/x families experience in accessing and using healthcare services from the perspective of PCPs.
The data was collected through structured interviews with 23 diverse PCPs across the US via videoconference or phone calls. Participants were recruited via snowball sampling. Two reviewers used an inductive coding approach to conduct qualitative thematic analysis. The Rigorous and Accelerated Data Reduction (RADaR) technique was used to extract relevant data and organize it into relevant categories.
Some of the themes identified reflect the experiences of individuals in the diagnostic process and subsequent care: 1) Family members are usually the first ones to notice the symptoms, 2) Delays in seeking care might be partially influenced by denial from individuals and their families, 3) Language congruency promotes the disclosure of symptoms, 4) Care that is linguistically and literacy appropriate requires additional support of patients and families, and 5) Caregiving expectations and preferences by Latino/a/e/x families do not shield caregivers from feeling burnout. Overall, PCPs reflected that the experiences of individuals are highly influenced by socioeconomic factors, which also influence their care plans.
Most Latino/a/e/x older adults with ADRD will be cared for by a PCP at some point during their disease, which means that they require additional support and resources at primary care appointments to address the barriers to accessing care services and enhance health equity in Latino/a/e/x communities.
在美国生活的拉丁裔人群中，阿尔茨海默病及相关痴呆症（ADRD）的诊断不足、误诊和治疗不足的情况尤为严重。拉丁裔家庭获得ADRD护理者支持服务的机会也很少，且抑郁症发病率很高。初级保健提供者（PCP）是患者及其家人的第一接触点，他们对于了解与获得服务差距相关的因素至关重要。本项目旨在从初级保健提供者的角度反思拉丁裔家庭在获得和使用医疗服务方面所面临的障碍。
通过视频会议或电话对美国各地23名不同的初级保健提供者进行结构化访谈来收集数据。通过滚雪球抽样招募参与者。两名评审员采用归纳编码方法进行定性主题分析。使用严格加速数据缩减（RADaR）技术提取相关数据并将其组织成相关类别。
确定的一些主题反映了个体在诊断过程及后续护理中的经历：1）家庭成员通常是最先注意到症状的人；2）寻求护理的延迟可能部分受到个体及其家人否认情绪的影响；3）语言一致性促进症状的披露；4）语言和读写能力适宜的护理需要患者及其家人的额外支持；5）拉丁裔家庭的护理期望和偏好并不能使护理者免于倦怠感。总体而言，初级保健提供者反映，个体的经历受到社会经济因素的高度影响，而这些因素也会影响他们的护理计划。
大多数患有ADRD的拉丁裔老年人在患病期间的某个时候将由初级保健提供者进行护理，这意味着他们在初级保健预约时需要额外的支持和资源，以消除获得护理服务的障碍并增强拉丁裔社区的健康公平性。
