Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

Ana M. Progovac; Dharma E. Cortés; Valeria Chambers; Jonathan Delman; Deborah Delman; Danny McCormick; Esther Lee; Selma De Castro; María José Sánchez Román; Natasha A. Kaushal; Timothy B. Creedon; Rajan A. Sonik; Catherine Rodriguez Quinerly; Caryn R. R. Rodgers; Leslie B. Adams; Ora Nakash; Afsaneh Moradi; Heba Abolaban; Tali Flomenhoft; Ruth Nabisere; Ziva Mann; Sherry Shu-Yeu Hou; Farah N. Shaikh; Michael Flores; Dierdre Jordan; Nicholas J. Carson; Adam C. Carle; Frederick Lu; Nathaniel M. Tran; Margo Moyer; Benjamin L. Cook

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Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

机译：了解过去的医疗保健歧视在寻求帮助和共享决策中的作用抑郁症治疗偏好

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As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino ( n = 4), non-Hispanic/Latino Black ( n = 8), or non-Hispanic/Latino White ( n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient–provider relationship. However, patients who had experienced health care discrimination faced greater challenges to forming trusting relationships with providers and thus engaging in shared decision-making processes.

机译：作为一项大型混合方法研究的一部分，我们对21名患有抑郁症的成年人进行了半结构式访谈，以了解过去的医疗歧视在帮助寻求抑郁症治疗和接受首选治疗方式方面所起的作用。我们招募志愿者是为了在参与者样本中实现种族/民族背景的异质性和医疗保健歧视的历史。参与者为西班牙裔/拉丁裔（n=4）、非西班牙裔/拉丁裔黑人（n=8）或非西班牙裔/拉丁裔白人（n=9）。据报道，有12人因种族/民族、语言、感知的社会阶层和/或心理健康诊断而受到医疗歧视。医疗歧视加剧了来自不同背景或有污名化心理健康状况的患者开始和继续接受抑郁症治疗的障碍。治疗偏好以流动的形式出现，并由在值得信赖的患者-提供者关系中做出的共同决定决定决定。然而，经历过医疗歧视的患者在与提供者建立信任关系，从而参与共同决策过程方面面临更大的挑战。

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来源
《Qualitative health research》 |2020年第12期|共18页
作者
Ana M. Progovac; Dharma E. Cortés; Valeria Chambers; Jonathan Delman; Deborah Delman; Danny McCormick; Esther Lee; Selma De Castro; María José Sánchez Román; Natasha A. Kaushal; Timothy B. Creedon; Rajan A. Sonik; Catherine Rodriguez Quinerly; Caryn R. R. Rodgers; Leslie B. Adams; Ora Nakash; Afsaneh Moradi; Heba Abolaban; Tali Flomenhoft; Ruth Nabisere; Ziva Mann; Sherry Shu-Yeu Hou; Farah N. Shaikh; Michael Flores; Dierdre Jordan; Nicholas J. Carson; Adam C. Carle; Frederick Lu; Nathaniel M. Tran; Margo Moyer; Benjamin L. Cook;
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作者单位

Cambridge Health Alliance;

Cambridge Health Alliance;

The Transformation Center Roxbury;

University of Massachusetts Medical School;

The Transformation Center Roxbury;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Boston University School of Public Health;

Cambridge Health Alliance;

Cambridge Health Alliance;

The Transformation Center Roxbury;

Albert Einstein College of Medicine;

Cambridge Health Alliance;

Smith College School for Social Work;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

James M. Anderson Center for Health Systems Excellence Department of Pediatrics Cincinnati;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

Cambridge Health Alliance;

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原文格式 PDF
正文语种 eng
中图分类保健组织与事业（卫生事业管理）;
关键词
depression; mental health and illness; race; racism; social issues; qualitative; semi-structured interviews; psychiatry; United States of America;

机译：抑郁症;心理健康和疾病;种族;种族主义;社会问题;定性;半结构化访谈;精神病学;美国;

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Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

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