Document Detail


Patient centeredness in medical encounters requiring an interpreter.
MedLine Citation:
PMID:  10781779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Patient-centered interviewing is associated with greater patient satisfaction and better medical outcomes than traditional encounters, but actively seeking patients' views of their illnesses and encouraging patients to express expectations, thoughts, and feelings is difficult in encounters that require an interpreter. We sought to examine physicians' use of the patient-centered approach with patients who required the assistance of an interpreter. SUBJECTS and METHODS: A cross-sectional sample of patients was videorecorded during visits with physicians at a multi-ethnic, university-affiliated, primary care clinic. Nineteen medical encounters of Spanish-speaking patients who required an interpreter and 19 matched English-speaking encounters were coded for frequency that patients mentioned symptoms, feelings, expectations, and thoughts (collectively called "offers"). Physicians' responses were coded as ignoring, closed, open, or facilitative of further discussion. RESULTS: English-speaking patients made a mean (+/- SD) of 20 +/- 11 offers, compared with 7 +/- 4 for Spanish-speaking patients (P = 0.001). Spanish-speaking patients also were less likely to receive facilitation from their physicians and were more likely to have their comments ignored (P <0.005). English-speaking patients usually received an answer or acknowledgment to their questions even if the physicians did not encourage further discussion on the topic. CONCLUSION: Spanish-speaking patients are at a double disadvantage in encounters with English-speaking physicians: these patients make fewer comments, and the ones they do make are more likely to be ignored. The communication difficulties may result in lower adherence rates and poorer medical outcomes among Spanish-speaking patients.
Authors:
R Rivadeneyra; V Elderkin-Thompson; R C Silver; H Waitzkin
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  108     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-16     Completed Date:  2000-06-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  470-4     Citation Subset:  AIM; IM    
Affiliation:
School of Social Ecology, University of California, Irvine, Irvine, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Attitude to Health / ethnology*
California
Central America / ethnology
Communication Barriers*
Cross-Sectional Studies
Emigration and Immigration*
Female
Hispanic Americans / psychology*
Humans
Interviews as Topic / methods*
Male
Mexico / ethnology
Middle Aged
Patient-Centered Care / methods*
Physician-Patient Relations*
Translating*
Videotape Recording
Grant Support
ID/Acronym/Agency:
1 RO1 MH 47536/MH/NIMH NIH HHS
Comments/Corrections
Comment In:
Am J Med. 2000 Oct 15;109(6):515   [PMID:  11184776 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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