The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients.
The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients.
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非裔美国人、西班牙裔和白人初级保健患者对抑郁症治疗的可接受性。
DOI：
10.1097/01.mlr.0000053228.58042.e4
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Ford,DanielE
中科院分区：
文献类型：
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作者：
Cooper,LisaA;Gonzales,JuniusJ;Gallo,JosephJ;Rost,KathrynM;Meredith,LisaS;Rubenstein,LisaV;Wang,Nae-Yuh;Ford,DanielE
背景：与白色患者相比，少数民族患者较少接受与指南一致的抑郁症治疗。目前还不确定是否种族和民族差异存在于患者的信念，态度和治疗偏好。方法：对829名成年患者进行电话调查（659名非西班牙裔白人，97名非裔美国人，73西班牙裔）从美国各地的初级保健办公室招募，在过去一个月内报告1周或更长时间的抑郁情绪或兴趣丧失，并符合以下标准：在过去的一年里，抑郁症发作。在这个队列中，我们检查了非裔美国人、西班牙裔美国人和白人在抗抑郁药物的可接受性和个体咨询的可接受性方面的差异。（调整后的OR，0.30; 95% CI，0.19-0.48）和西班牙裔（调整后的OR，0.44; 95% CI，0.26-0.76）发现抗抑郁药物可接受的几率低于白色人。与白色人相比，非裔美国人发现咨询可接受的几率较低（调整后OR，0.63; 95%CI，0.35-1.12），西班牙裔人发现咨询可接受的几率较高（调整后OR，3.26; 95%CI，1.08-9.89）。一些消极的信念，治疗中更普遍的少数民族，但这些信念的调整并没有解释差异的可接受性治疗depression.Conclusions。非裔美国人是不太可能比白色人找到抗抑郁药物可接受的。与白色人相比，西班牙裔人不太可能接受抗抑郁药物治疗，而更可能接受心理咨询。种族和民族的差异，在信仰的治疗方式被发现，但并没有解释差异的抑郁症治疗的可接受性。临床医生在协商抑郁症的治疗决定时应该考虑患者的文化和社会背景。未来的研究应确定其他态度障碍，少数民族患者的抑郁症护理。
Background.Ethnic minority patients are less likely than white patients to receive guideline-concordant care for depression. It is uncertain whether racial and ethnic differences exist in patient beliefs, attitudes, and preferences for treatment.Methods.A telephone survey was conducted of 829 adult patients (659 non-Hispanic whites, 97 African Americans, 73 Hispanics) recruited from primary care offices across the United States who reported 1 week or more of depressed mood or loss of interest within the past month and who met criteria for Major Depressive Episode in the past year. Within this cohort, we examined differences among African Americans, Hispanics, and whites in acceptability of antidepressant medication and acceptability of individual counseling.Results.African Americans (adjusted OR, 0.30; 95% CI 0.19–0.48) and Hispanics (adjusted OR, 0.44; 95% CI, 0.26–0.76) had lower odds than white persons of finding antidepressant medications acceptable. African Americans had somewhat lower odds (adjusted OR, 0.63; 95% CI, 0.35–1.12), and Hispanics had higher odds (adjusted OR, 3.26; 95% CI, 1.08–9.89) of finding counseling acceptable than white persons. Some negative beliefs regarding treatment were more prevalent among ethnic minorities; however adjustment for these beliefs did not explain differences in acceptability of treatment for depression.Conclusions.African Americans are less likely than white persons to find antidepressant medication acceptable. Hispanics are less likely to find antidepressant medication acceptable, and more likely to find counseling acceptable than white persons. Racial and ethnic differences in beliefs about treatment modalities were found, but did not explain differences in the acceptability of depression treatment. Clinicians should consider patients’ cultural and social context when negotiating treatment decisions for depression. Future research should identify other attitudinal barriers to depression care among ethnic minority patients.