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新泽西州一个健康结果较差的县中,医疗不信任对医疗保健行为的影响及启示

Influences and Implications of Medical Mistrust on Healthcare Behaviors in a Low Health Outcomes County in the State of New Jersey.

作者信息

Johnson Dale, Javed Adeena, Byrnes Nathaniel J, Jones Anne C, Bertsch Kristin N

机构信息

Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA.

出版信息

J Community Health. 2025 May 27. doi: 10.1007/s10900-025-01483-5.

Abstract

Medical mistrust is an ongoing concern in the United States, with patient confidence in both individual practitioners and institutions decreasing sharply in recent years. Atlantic County, New Jersey has some of the worst health outcomes in the state and is below the national average. This study sought to investigate medical mistrust by recruiting participants to complete a survey and/or health screening at 12 food pantry distribution events throughout Atlantic County (N = 124). The mean score for the Medical Mistrust Index was 19.06 (SD = 5.6) for participants who reported receiving the annual influenza vaccine and 16.05 (SD = 4.7) for participants who did not report receiving the vaccine (p = 0.002). Participants who reported an "Excellent" self-perception of overall (M = 13.7, SD = 4.6) and dental health (M = 14.6, SD = 5.5) had significantly less trust relative to their counterparts. There was no significant difference in self-perception of mental health and trust. While not statistically significant, a positive correlation was observed between trust and the number of healthcare information sources used: participants reporting use of 1 source had the lowest trust (M = 16.82, SD = 5.73), while those using 2 (M = 17.86, SD = 4.48; p =.509), 3 (M = 17.33, SD = 0.87; p =.536), or ≥ 4 sources (M = 19.38, SD = 3.97; p =.086) showed progressively higher trust. Our findings highlight the responsibility of improving medical mistrust falls on both providers and patients to take agency of their care.

摘要

医疗不信任在美国一直是个令人担忧的问题,近年来患者对个体从业者和医疗机构的信心急剧下降。新泽西州大西洋县的健康状况在该州是最差的一些地区之一,且低于全国平均水平。本研究旨在通过招募参与者在大西洋县12个食品救济站分发活动中完成一项调查和/或健康筛查来调查医疗不信任情况(N = 124)。报告接种了年度流感疫苗的参与者的医疗不信任指数平均得分为19.06(标准差 = 5.6),未报告接种疫苗的参与者的平均得分为16.05(标准差 = 4.7)(p = 0.002)。报告对整体健康(M = 13.7,标准差 = 4.6)和牙齿健康(M = 14.6,标准差 = 5.5)有“优秀”自我认知的参与者相对于其同龄人明显更缺乏信任。心理健康自我认知与信任之间没有显著差异。虽然无统计学意义,但观察到信任与使用的医疗保健信息源数量之间存在正相关:报告使用1个信息源的参与者信任度最低(M = 16.82,标准差 = 5.73),而使用2个(M = 17.86,标准差 = 4.48;p = 0.509)、3个(M = 17.33,标准差 = 0.87;p = 0.536)或≥4个信息源(M = 19.38,标准差 = 3.97;p = 0.086)的参与者信任度逐渐更高。我们的研究结果强调,改善医疗不信任的责任落在提供者和患者双方身上,他们都要积极参与自身的医疗护理。

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