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社会人口学特征和健康的社会决定因素在影响患者与医护人员沟通的感知质量方面的作用。

The Role of Sociodemographic Characteristics and Social Determinants of Health in Influencing the Perceived Quality of Patient-Provider Communication.

作者信息

Eldawy Nada, Kaleem Sahar, Jhumkhawala Vama, Okwaraji Goodness, Jimenez Samantha, Sohmer Joshua, Mejia Maria, Kitsantas Panagiota, Sacca Lea

机构信息

Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA.

出版信息

Nurs Rep. 2025 Mar 19;15(3):113. doi: 10.3390/nursrep15030113.

Abstract

: Patient-centered communication is a critical process in high-quality healthcare that emphasizes the reciprocal sharing of information between providers and patients to ensure care aligns with the patient's needs, preferences, and personal values. A significant challenge arises from the healthcare provider's time constraints during clinical encounters and the lack of adequate training on how to adopt a patient-centered communication style that addresses patient concerns, making it difficult to foster an environment conducive to shared decision making. These issues are further exacerbated by cultural and language barriers, along with low levels of health literacy and social determinants of health (SDoHs), which complicate efforts to deliver patient-centered care. : This study examined quality criteria for patient-provider communication (PPC) and their associations with sociodemographic characteristics and SDoHs on housing, transportation, and food insecurity. : This retrospective cross-sectional study analyzed data from the 2022 Health Information National Trends Survey (HINTS-6) national dataset. Associations between PPC and sociodemographic variables were tested using the chi-squared test. Binary logistic regression was carried out to examine the association between three PPC criteria and each of the sociodemographic characteristics and patient comfort in disclosing information on SDoHs. : Bivariate analyses showed statistically significant associations for age, occupation status, marital status, Hispanic origin, and race across all three PPC criteria. Significant associations were reported for education and income for the two criteria related to being given the chance to ask questions and being involved in healthcare decisions. Finally, significant associations were reported for all PPC criteria and patient comfort levels in discussing SDoHs. : Findings from this paper provide insight for enhancing the quality of PCC in underserved populations, particularly when it comes to informing the design of evidence-based cervical cancer screening interventions which are culturally centered around the patients' needs and that integrate PPC as a foundational component.

摘要

以患者为中心的沟通是高质量医疗保健中的一个关键过程,它强调医疗服务提供者与患者之间相互分享信息,以确保医疗服务符合患者的需求、偏好和个人价值观。在临床诊疗过程中,医疗服务提供者面临时间限制,且缺乏关于如何采用以患者为中心的沟通方式来解决患者关切问题的充分培训,这带来了重大挑战,使得营造有利于共同决策的环境变得困难。文化和语言障碍,以及低水平的健康素养和健康的社会决定因素(SDoHs)进一步加剧了这些问题,使提供以患者为中心的医疗服务的努力变得更加复杂。

本研究考察了患者与医疗服务提供者沟通(PPC)的质量标准及其与社会人口学特征以及住房、交通和粮食不安全方面的健康社会决定因素之间的关联。

这项回顾性横断面研究分析了2022年健康信息国家趋势调查(HINTS - 6)全国数据集的数据。使用卡方检验来检验PPC与社会人口学变量之间的关联。进行二元逻辑回归以检验三个PPC标准与每个社会人口学特征以及患者在披露健康社会决定因素信息时的舒适度之间存在的关联。

双变量分析显示,在所有三个PPC标准方面,年龄、职业状况、婚姻状况、西班牙裔血统和种族存在统计学上的显著关联。在与有机会提问和参与医疗决策相关的两个标准方面,教育程度和收入存在显著关联。最后,在讨论健康社会决定因素时,所有PPC标准与患者舒适度水平之间均存在显著关联。

本文的研究结果为提高服务不足人群的患者与医疗服务提供者沟通质量提供了见解,特别是在为以患者需求为文化核心并将PPC作为基础组成部分的循证宫颈癌筛查干预措施的设计提供信息方面。

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