Aspects of Culturally Competent Care are Associated With Less Emotional Burden Among Patients With Diabetes

Slean, Geraldine R.; Jacobs, Elizabeth A.; Lahiff, Maureen; Fisher, Lawrence; Fernández, Alicia

doi:10.1097/mlr.0b013e3182641127

Cited by 22 publications

(19 citation statements)

References 25 publications

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“…This association may be due to decreasing insularity of social networks that buffer recent Latino immigrants, increasing contact with NLWs, African Americans and others beyond the immigrant community, and longer exposure to racialization processes in the US for Hispanic immigrants with longer US residence [42–44]. Our findings of higher DRD among Latinos are consistent with other studies [7, 45, 46]. Even when experienced less frequently, discrimination may pose an additional stressor for this population, which faces a constellation of stressors and low socioeconomic position, and may compound existing health-related stressors, including DRD.…”

Section: Discussionsupporting

confidence: 90%

Everyday Discrimination, Diabetes-Related Distress, and Depressive Symptoms Among African Americans and Latinos with Diabetes

LeBrón¹,

Valerio²,

Kieffer³

et al. 2013

J Immigrant Minority Health

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It is not known how discrimination might affect diabetes-related distress (DRD), an important correlate of diabetes outcomes. We examined correlates of discrimination and the influence of discrimination on DRD and depressive symptoms (DS) for African Americans and Latinos with type 2 diabetes. We analyzed survey data (n = 157) collected at enrollment into a diabetes management intervention. Using multiple linear regression, we examined correlates of discrimination and the association between discrimination and DRD and DS. Discrimination was significantly associated with higher DRD for Latinos (b 1.58, 95 % CI 1.08, 2.31, p < 0.05), but not significant for African Americans (b 0.96, 95 % CI 0.59, 1.57). Discrimination was marginally significantly associated with more DS for Latinos (b 1.43, 95 % CI 0.97, 2.12, p < 0.10), but not significant for African Americans (b 1.21, 95 % CI 0.87, 1.70). These findings suggest the need to address stressors unique to racial/ethnic minorities to improve diabetes-related outcomes.

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Section: Discussionsupporting

confidence: 90%

Everyday Discrimination, Diabetes-Related Distress, and Depressive Symptoms Among African Americans and Latinos with Diabetes

LeBrón¹,

Valerio²,

Kieffer³

et al. 2013

J Immigrant Minority Health

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“…Examining the subscales, consisting with other studies the nature of patients’ distress in our sample appeared to stem mostly from the emotional toll of the disease and from the difficulties in managing their medication regimen 5 17. Themes included within the emotional burden subscale deal with a lack of physical and mental energy, feeling angry, scared, depressed, out of control, overwhelmed or hopeless because of their diabetes.…”

Section: Discussionmentioning

confidence: 94%

Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes

Pandit

Bailey²,

Curtis³

et al. 2014

J Epidemiol Community Health

100

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“…3638 LEP patients report more adverse medication events, less trust in provider, and less satisfaction with the medical encounter. 12,3639 Providers caring for LEP patients report that language barriers make it difficult to elicit symptoms, reconcile medications, and establish rapport. 13 Why then, did we find no differences in medication adherence by patient-provider language concordance and only small differences in adherence between LEP and English-speaking Latinos?…”

Section: Discussionmentioning

confidence: 99%

Adherence to Newly Prescribed Diabetes Medications Among Insured Latino and White Patients With Diabetes

et al. 2017

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IMPORTANCE Medication adherence is essential to diabetes care. Patient-physician language barriers may affect medication adherence among Latino individuals.OBJECTIVE To determine the association of patient race/ethnicity, preferred language, and physician language concordance with patient adherence to newly prescribed diabetes medications.DESIGN, SETTING, AND PARTICIPANTS This observational study was conducted from January 1, 2006, to December 31, 2012, at a large integrated health care delivery system with professional interpreter services. Insured patients with type 2 diabetes, including English-speaking white, English-speaking Latino, or limited English proficiency (LEP) Latino patients with newly prescribed diabetes medication.EXPOSURES Patient race/ethnicity, preferred language, and physician self-reported Spanish-language fluency.MAIN OUTCOMES AND MEASURES Primary nonadherence (never dispensed), early-stage nonpersistence (dispensed only once), late-stage nonpersistence (received Ն2 dispensings, but discontinued within 24 months), and inadequate overall medication adherence (>20% time without sufficient medication supply during 24 months after initial prescription).RESULTS Participants included 21 878 white patients, 5755 English-speaking Latino patients, and 3205 LEP Latino patients with a total of 46 131 prescriptions for new diabetes medications. Among LEP Latino patients, 50.2% (n = 1610) had a primary care physician reporting high Spanish fluency. For oral medications, early adherence varied substantially: 1032 LEP Latino patients (32.2%), 1565 English-speaking Latino patients (27.2%), and 4004 white patients (18.3%) were either primary nonadherent or early nonpersistent. Inadequate overall adherence was observed in 1929 LEP Latino patients (60.2%), 2975 English-speaking Latino patients (51.7%), and 8204 white patients (37.5%). For insulin, early-stage nonpersistence was 42.8% among LEP Latino patients (n = 1372), 34.4% among English-speaking Latino patients (n = 1980), and 28.5% among white patients (n = 6235). After adjustment for patient and physician characteristics, LEP Latino patients were more likely to be nonadherent to oral medications and insulin than English-speaking Latino patients (relative risks from 1.11 [95% CI, 1.06-1.15] to 1.17 [95% CI, 1.02-1.34]; P < .05) or white patients (relative risks from 1.36 [95% CI, 1.31-1.41] to 1.49 [95% CI, 1.32-1.69]; P < .05). English-speaking Latino patients were more likely to be nonadherent compared with white patients (relative risks from 1.23 [95% CI, 1.19-1.27] to 1.30 [95% CI, 1.23-1.39]; P < .05). Patient-physician language concordance was not associated with rates of nonadherence among LEP Latinos (relative risks from 0.92 [95% CI, 0.71-1.19] to 1.04 [95% CI, 0.97-1.1]; P > .28). CONCLUSIONS AND RELEVANCENonadherence to newly prescribed diabetes medications is substantially greater among Latino than white patients, even among English-speaking Latino patients. Limited English proficiency Latino patients are more likely to be nonadherent than En...

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Aspects of Culturally Competent Care are Associated With Less Emotional Burden Among Patients With Diabetes

Abstract: Patient report of better doctor communication behavior and higher trust in physician are inversely associated with high EB among patients with diabetes. Further research should determine whether interventions improving patient physician communication and trust can lower the EB of diabetes.

Cited by 22 publications

References 25 publications

Everyday Discrimination, Diabetes-Related Distress, and Depressive Symptoms Among African Americans and Latinos with Diabetes

Everyday Discrimination, Diabetes-Related Distress, and Depressive Symptoms Among African Americans and Latinos with Diabetes

Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes

Adherence to Newly Prescribed Diabetes Medications Among Insured Latino and White Patients With Diabetes

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