Jenny Park1, Mary Catherine Beach2, Dingfen Han3, Richard D Moore3, P Todd Korthuis4, Somnath Saha5. 1. Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA. 3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Department of Medicine, Oregon Health and Science University, Portland, OR, USA. 5. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Medicine, Oregon Health and Science University, Portland, OR, USA; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA. Electronic address: sahas@ohsu.edu.
Abstract
OBJECTIVE: In a previous study of patients newly enrolled in HIV care, we observed that clinicians were less likely to address emotional issues expressed by African-American patients compared to whites. We sought to verify and expand these findings in a larger group of patients established in HIV care. METHODS: We used VR-CoDES to analyze transcripts from 342 audio-recorded medical visits in the United States. We used random intercept multilevel logistic regression to assess associations between patient and clinician characteristics and patterns of emotional talk. RESULTS: African-American patients were less likely than others to spontaneously express emotions (OR 0.50; 95 % CI 0.29-0.85). Clinicians, who were predominantly white, were more likely to respond to emotional expressions by African-American patients explicitly (OR 1.56; 95 % CI 1.11-2.20) but less likely to offer neutral/passive responses that provide space for emotional conversation (OR 0.56; 95 % CI 0.37-0.84) and more likely to block discussion of the emotional issue (OR 2.20; 95 % CI 1.05-4.63). Emotional talk did not vary by patient age or gender. CONCLUSION: These results confirm our prior findings, demonstrating less open emotional communication between African-American patients and their providers. PRACTICE IMPLICATIONS: Addressing racial differences in communicating about emotions may reduce disparities in patient-clinician relationships. Published by Elsevier B.V.
OBJECTIVE: In a previous study of patients newly enrolled in HIV care, we observed that clinicians were less likely to address emotional issues expressed by African-American patients compared to whites. We sought to verify and expand these findings in a larger group of patients established in HIV care. METHODS: We used VR-CoDES to analyze transcripts from 342 audio-recorded medical visits in the United States. We used random intercept multilevel logistic regression to assess associations between patient and clinician characteristics and patterns of emotional talk. RESULTS: African-American patients were less likely than others to spontaneously express emotions (OR 0.50; 95 % CI 0.29-0.85). Clinicians, who were predominantly white, were more likely to respond to emotional expressions by African-American patients explicitly (OR 1.56; 95 % CI 1.11-2.20) but less likely to offer neutral/passive responses that provide space for emotional conversation (OR 0.56; 95 % CI 0.37-0.84) and more likely to block discussion of the emotional issue (OR 2.20; 95 % CI 1.05-4.63). Emotional talk did not vary by patient age or gender. CONCLUSION: These results confirm our prior findings, demonstrating less open emotional communication between African-American patients and their providers. PRACTICE IMPLICATIONS: Addressing racial differences in communicating about emotions may reduce disparities in patient-clinician relationships. Published by Elsevier B.V.
Entities:
Keywords:
Emotion; HIV; Health disparities; Patient-Provider communication
Authors: Mary Catherine Beach; Somnath Saha; P Todd Korthuis; Victoria Sharp; Jonathon Cohn; Ira Wilson; Susan Eggly; Lisa A Cooper; Debra Roter; Andrea Sankar; Richard Moore Journal: J Gen Intern Med Date: 2010-03-18 Impact factor: 5.128
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