Patient race/ethnicity and quality of patient-physician communication during medical visits
Patient race/ethnicity and quality of patient-physician communication during medical visits
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DOI：
10.2105/ajph.94.12.2084
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发表时间：
2004-12-01
影响因子：
12.7
通讯作者：
Cooper, LA
中科院分区：
文献类型：
--
作者：
Johnson, RL;Roter, D;Cooper, LA
目标。我们研究了患者种族/民族与就诊时医患沟通之间的关系。我们使用1998年和2002年收集的录音带和问卷调查数据来确定非裔美国人和白人患者的就诊沟通质量是否不同。我们分析了458名非裔美国人和白人患者的数据，他们在巴尔的摩、马里兰州、华盛顿特区和北弗吉尼亚大都会区访问了61名医生。评估医疗访问的沟通过程、以患者为中心和情绪基调（影响）的结果测量来源于由独立评分者编码的录音带。与白人患者相比，医生在与非裔美国患者的交流中占了23%的语言优势，而以患者为中心的交流则少了33%。此外，非裔美国患者和他们的医生都比白人患者和他们的医生表现出更低的积极影响水平。非裔美国人与白人患者在就诊期间的医患沟通有所不同。提高医生以患者为中心的意识和对非裔美国人患者的情感暗示的认识，并激活非裔美国人患者参与其医疗保健的干预措施是解决医疗保健中种族/民族差异的重要策略。
Objectives. We examined the association between patient race/ethnicity and patient-physician communication during medical visits.Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md-Washington, DC-Northern Virginia metropolitan area. Outcome measures that assessed the communication process, patient-centeredness, and emotional tone (affect) of the medical visit were derived from audiotapes coded by independent raters.Results. Physicians were 23% more verbally dominant and engaged in 33% less patient-centered communication with African American patients than with White patients. Furthermore, both African American patients and their physicians exhibited lower levels of positive affect than White patients and their physicians did.Conclusions. Patient-physician communication during medical visits differs among African American versus White patients. Interventions that increase physicians' patient-centeredness and awareness of affective cues with African Americans patients and that activate African American patients to participate in their health care are important strategies for addressing racial/ethnic disparities in health care.