MEASURING INTERPERSONAL PROCESSES IN DIVERSE PATIENTS

摘要（Abstract）。 有大量证据表明， 社会经济地位较低者或少数群体的健康 而不是他们的对手。 很少有人注意到 医疗服务的质量，虽然技术服务是众所周知的较差， 一些种族/民族团体。 一个新兴的假设，这些健康和 技术关怀差异是关怀的人际过程差异 发生在患者和临床医生之间。 在前期工作中，该团队 开发和经验测试的多维概念框架， 人际交往过程，包括种族和 社会经济上不同的群体。 该框架得到了一位 测量每个概念的调查工具，但需要更多的工作， 确保措施的可比性。 该项目旨在最后确定框架 和自我报告调查的人际关系的过程是概念上和 在心理测量上适合于非裔美国人、拉丁美洲人和白色患者。 该仪器的主要目的是检查人际关系 过程作为一种机制，通过它来解释健康和技术护理 差距。 受试者是来自大型医院的18岁及以上的患者。 位于北方加州的多专业团体实践环境，按种族服务， 不同种族和社会经济背景的患者。 这项横向研究的具体目标是： 1. 完善基于框架和工具的人际进程 新的定性研究（焦点小组，认知测试）， 3个人种/种族组的第1代研究数据， 和 2. 对3组患者进行现场测试 （每组N= 1，200，400）并评估心理测量学特性 和有效性的假设措施，使用结构 方程建模，以确保最终测量具有类似的 3组之间的测量属性和有效性。 由此产生的工具可以用来检查人际过程如何 与技术过程和临床结果有关。 干预措施 从这些研究中产生的结果可能有助于提高护理质量 为不同的群体。

DESCRIPTION: (from the abstract). There is substantial evidence of poorer health for persons with lower socioeconomic status or from minority groups than for their counterparts. Little attention has been paid to the role of the quality of medical care, although technical care is known to be poorer for some racial/ethnic groups. One emerging hypothesis for these health and technical care disparities is differences in interpersonal processes of care that occur between patients and clinicians. In preliminary work, this team developed and empirically tested a multidimensional conceptual framework of interpersonal processes that incorporated views of ethnically and socioeconomically diverse groups. The framework was generally confirmed by a survey instrument measuring each of the concepts, but more work is needed to assure comparability of measures. This project aims to finalize the framework and self-report survey of interpersonal processes to be conceptually and psychometrically adequate for African American, Latino, and white patients. The main propose of the instrument is to enable examination of interpersonal processes as a mechanism by which to explain health and technical care disparities. Subjects are patients aged 18 and older from a large multispecialty group practice setting in Northern California serving racially, ethnically, and socioeconomically diverse patients. The specific aims of this cross-sectional study are to: 1. refine the interpersonal processes framework and instrument based on new qualitative studies (focus groups, cognitive testing) and data from the 1st generation study in the 3 racial/ethnic groups, and 2. field test the refined instrument in patients from 3 groups (N=1,200, 400 per group) and evaluate the psychometric properties and validity of the hypothesized measures using structural equation modeling to assure that the final measures have similar measurement properties and validity across the 3 groups. The resulting instrument can be used to examine how interpersonal processes are related to technical processes and clinical outcomes. Interventions arising from such studies could contribute to quality improvements in caring for diverse groups.