Sanderson B K, Raczynski J M, Cornell C E, Hardin M, Taylor H A
Department of Medicine and Center for Health Promotion, University of Alabama at Birmingham, USA.
Am J Epidemiol. 1998 Oct 15;148(8):741-9. doi: 10.1093/oxfordjournals.aje.a009695.
Despite the proven benefits of many cardiac procedures, some are used less frequently for African Americans than for white patients with known or suspected coronary disease. This study explored differences between ethnic groups that may affect patient recall of physician recommendations of cardiac procedures. Also examined were patients' responses when asked about adhering to those recommendations. The data examined were collected from interviews with 1,333 African American and white hospital inpatients with known coronary disease admitted to the Birmingham-Black Health Seeking for Coronary Heart Disease Project (1989-1990) in Alabama. Respondents were asked to recall previous health care encounters, physician recommendations of cardiac procedures, and adherence to those recommendations. Compared with whites, fewer African American patients recalled physicians recommending some cardiac procedures. If procedure recommendations were recalled, no ethnic differences were found in patient recall of adhering to those recommendations. Predictors of recall of the recommended procedures were identified by multivariate logistic regression. Patients' knowledge of having coronary disease was the common factor that predicted their recall of all cardiac procedures. Other predictor variables included some cardiac risk factors and symptoms, socioeconomic status, and ethnicity. Although health care practice is influenced by many factors, it is important to examine variables that may lead to a reduction in ethnic disparities in coronary disease morbidity and mortality.
尽管许多心脏手术已被证实有益，但在已知或疑似患有冠心病的患者中，一些手术在非裔美国人中的使用频率低于白人患者。本研究探讨了可能影响患者对心脏手术医生建议回忆的种族差异。还研究了患者在被问及是否遵循这些建议时的反应。所检查的数据来自对1333名患有已知冠心病的非裔美国人和白人住院患者的访谈，这些患者入住了阿拉巴马州伯明翰黑人冠心病寻求健康项目（1989 - 1990年）。受访者被要求回忆之前的医疗接触、心脏手术的医生建议以及对这些建议的遵循情况。与白人相比，较少有非裔美国患者回忆起医生推荐某些心脏手术。如果回忆起手术建议，在患者对遵循这些建议的回忆方面未发现种族差异。通过多因素逻辑回归确定了推荐手术回忆的预测因素。患者对患有冠心病的认知是预测他们对所有心脏手术回忆的共同因素。其他预测变量包括一些心脏危险因素和症状、社会经济地位以及种族。尽管医疗实践受多种因素影响，但研究可能导致冠心病发病率和死亡率种族差异减少的变量很重要。
