Differences Between Current and Desired Physician Hypertension Management Roles Among Chinese American Seniors: a Qualitative Study.
Differences Between Current and Desired Physician Hypertension Management Roles Among Chinese American Seniors: a Qualitative Study.
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华裔美国老年人当前和期望的医生高血压管理角色之间的差异：一项定性研究。
DOI：
10.1007/s11606-020-06012-9
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发表时间：
2020
影响因子：
5.7
通讯作者：
Sarkisian,Catherine
中科院分区：
文献类型：
--
作者：
Chang,Emiley;Lin,Victor;Goh,Regine;Chan,Canossa;Ong,MichaelK;Hui,Edward;Sarkisian,Catherine
背景虽然患者-医生种族一致性与更好的感知共同决策相关，但中国移民报告的护理质量较低，且无论一致性如何，高血压治疗不足。我们使用角色理论来探讨华裔美国老年人对高血压管理中当前医生角色和期望医生角色的描述之间的差异。我们从一家老年健康中心招募了15名参与者，进行语言匹配的访谈和血压（BP）检查。参与者描述了当前和期望的医生活动高血压管理。双语研究助理翻译录音。使用主题分析，一个三人小组独立审查和编码的成绩单，以确定主题的医生在高血压管理中的作用，差异进行了讨论，以达成共识。主题的有效性进行了检查，在随后的四个焦点groups.ResultsWe在2014年完成了采访。受访者的平均年龄为70.6岁; 7名女性，5名收缩压超过150 mmHg。所有受访者都报告有种族和语言一致的初级保健提供者，至少开了一种BP药物，并有医疗保险。三个主要主题包括当前和期望的医生在高血压管理中的角色：技术专家，同情的健康管家和健康教育家。目前和期望的医生角色的描述不同的所有主题，最突出的是同情的健康管家和健康教育家。参与者的愿望，但没有一贯的经验，人际交往或接受高血压生活方式的咨询，引用访问时间pressure.ConclusionsAmong这些华裔美国老年人，目前和理想的医生角色之间仍然存在差距，在高血压管理，特别是人际行为和教育。老年人降低这些角色的优先级，以应对感知的医生角色压力。增加对感知医生角色紧张的影响的关注可能会改善共同决策和高血压管理。
BackgroundThough patient-physician racial concordance correlates with better perceived shared decision-making, Chinese immigrants report low quality of care and have undertreated hypertension regardless of concordance.ObjectiveTo inform efforts to change physician behavior and improve quality of hypertension care, we used role theory to explore differences between Chinese American seniors’ descriptions of current and desired physician roles in hypertension management.DesignQualitative interviews.ParticipantsImmigrant Chinese Americans with hypertension age ≥ 65 years in Los Angeles County.ApproachWe recruited 15 participants from a senior wellness center for language-matched interviews and blood pressure (BP) checks. Participants described current and desired physician activities for hypertension management. Bilingual research assistants translated audio recordings. Using thematic analysis, a three-member team independently reviewed and coded transcripts to identify themes regarding physician roles in hypertension management; discrepancies were discussed to achieve consensus. Themes were checked for validity in four subsequent focus groups.ResultsWe completed interviews in 2014. Interviewees’ mean age was 70.6 years; seven were female and five had a systolic BP over 150 mmHg. All interviewees reported having race- and language-concordant primary care providers, were prescribed at least one BP medication, and had Medicare. Three major themes encompassed current and desired physician roles in hypertension management: technical expert, empathetic health steward, and health educator. Descriptions of current and desired physician roles differed for all themes, most prominently for empathetic health steward and health educator. Participants desired but did not consistently experience interpersonal engagement or receive hypertension lifestyle counseling, citing visit time pressures.ConclusionsAmong these Chinese American seniors, there remains a gap between current and desired physician roles in hypertension management, particularly interpersonal behaviors and education. Seniors deprioritized these roles in response to perceived physician role strain. Increased attention to the impact of perceived physician role strain might improve shared decision-making and hypertension management.