Ferguson J A, Weinberger M, Westmoreland G R, Mamlin L A, Segar D S, Greene J Y, Martin D K, Tierney W M
Center for Health Services Research, Roudebush Veterans Affairs Medical Center, the Division of General Internal Medicine, Indiana University School of Medicine, Indianapolis 46202, USA.
Arch Intern Med. 1998 Jul 13;158(13):1450-3. doi: 10.1001/archinte.158.13.1450.
While numerous studies suggest that African Americans receive fewer invasive cardiac procedures than whites, the basis for these treatment differences is not understood.
We conducted focus group sessions with patients who had received treatment in the hospital or the emergency department within the preceding 3 months for ischemic heart disease at 2 urban, university-affiliated hospitals.
Discussions with patients identified the following factors that influenced their decision making: clarity, simplicity, and consistency of treatment recommendations; advice from friends and family about whether to accept recommendations; availability to speak with others who accepted similar recommendations; and having honest and caring physicians. African American patients identified the following additional factors that influenced their decision making: perceptions of health care discrimination; perceptions of undesirable physician behavior; faith in God to control one's destiny; and patient-physician camaraderie.
Participants identified common issues influencing health care decision making, regardless of race. However, additional factors were expressed only by African American participants. These factors conveyed racial differences in perceptions of the health care system that may, in part, contribute to differences in health care decision making and treatment.
尽管众多研究表明非裔美国人接受的侵入性心脏手术比白人少，但这些治疗差异的原因尚不清楚。
我们在两家城市的大学附属医院对在过去3个月内在医院或急诊科接受过缺血性心脏病治疗的患者进行了焦点小组讨论。
与患者的讨论确定了以下影响他们决策的因素：治疗建议的清晰度、简单性和一致性；朋友和家人关于是否接受建议的意见；与接受类似建议的其他人交谈的机会；以及有诚实和关心患者的医生。非裔美国患者确定了以下额外影响他们决策的因素：对医疗保健歧视的看法；对不良医生行为的看法；对上帝控制命运的信仰；以及医患之间的情谊。
参与者确定了影响医疗保健决策的常见问题，无论种族如何。然而，只有非裔美国参与者表达了其他因素。这些因素反映了对医疗保健系统看法上的种族差异，这可能在一定程度上导致医疗保健决策和治疗的差异。
