US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Abstract

Hispanics in the U.S. experience significant health disparities. Using focus groups conducted in Spanish, we explored the perspectives of 172 Hispanic adults regarding their healthcare experiences. Many participants were female (64.5%) and primarily from Mexico (80%). Four major qualitative themes emerged: 1) provide us with information, 2) want attentive and respectful relationships, 3) want better care, and 4) perceived discrimination. Suboptimal patient-provider interactions were described. Research is needed to explore interventions that address these issues. Incorporating person-centered care principles and practices such as clear and understandable communication, culturally competent care, and customer service skills may benefit provider interactions with Hispanics.

Reliability and Validity of the Spoken Knowledge in Low Literacy in Diabetes in Measuring Diabetes Knowledge Among Hispanics With Type 2 Diabetes

“…3,4 Recent research with Hispanics living in regions not located along the Mexico-US border area indicated that Hispanics encounter barriers associated with a lack of health services that are culturally and linguistically tailored for Spanish-speaking patients or barriers to being able to receive timely care. [5][6][7] Receiving care in one's native language and that takes into consideration health literacy levels and cultural perspectives of nutrition, physical activity, treatments, and health beliefs has the potential to educate and empower patients in diabetes self-management behaviors and to become active partners in shared decision-making. 4,8 Given the diabetesrelated health disparities experienced by Hispanics and the barriers for Spanish-speaking patients, further investigation is warranted of circumstances that exacerbate diabetesrelated complications among this population.…”

“…Although previous studies reported association between diabetes knowledge and glycemic control, 15,17,22 the SKILLD was not significantly correlated with A1C in the current study. This may be explained by considering that other factors, such as socioeconomic factors and getting access to care, [5][6][7] might also contribute to glycemic control among Hispanics with T2DM. The SKILLD showed good convergent validity with duration of diabetes.…”

Exploring Factors Associated with Physical Activity in Latino Immigrants

“…Self-efficacy was also seen as important to general health promotion among Latino dyads with chronic illness (McEwen et al, 2017). Latino females continue to be at risk for health disparities due to fatigue (Chang et al, 2018) and lack of respectful relationships with the health care team (Amirehsani et al, 2017). So if nurses desire to increase PA in Latino females, interventions which build on self-efficacy in both individuals and families are an important way to start.…”

Patient perspectives on racial and ethnic implicit bias in clinical encounters: Implications for curriculum development

“…We developed the interview guide (Appendix) based on review of the literature related to racial discordance, trust, and discrimination in clinical encounters [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Questions focused on racial and ethnic bias, our construct of interest.…”

“…Evidence demonstrates this bias negatively impacts patient's perceptions of the clinical encounter [7][8][9] treatment recommendations [10], and trust [11][12][13][14]. Although studies from various countries have explored patients' perceptions of race and/or ethnicity and bias in medicine [6,12,[14][15][16][17][18][19][20][21][22][23][24][25], patient perspectives on and suggestions for restoring the clinical and/or therapeutic relationship once bias is perceived are not known. Understanding these perspectives could inform the development of innovations in medical student education addressing implicit bias in clinical encounters.…”