Medical care
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Multicenter Study Comparative Study
Impact of perceived discrimination in healthcare on patient-provider communication.
The impact of patients' perceptions of discrimination in healthcare on patient-provider interactions is unknown. ⋯ Perceptions of past racism and classism in healthcare settings may negatively impact the affective tone of subsequent patient-provider communication.
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Language discordance between patient and physician is associated with worse patient self-reported healthcare quality. As Hispanic patients have low rates of cardiovascular and cancer screening, we sought to determine whether patient-physician language concordance was associated with differences in rates of screening. ⋯ This study finds that Spanish-speaking patients cared for by language-concordant PCPs were not more likely to receive recommended screening for cardiovascular risk factors and cancer. Furthermore, language concordance was associated with lower likelihood colorectal cancer screening. Further research is needed to examine which conditions are optimal to improve cardiovascular and cancer screening for Spanish-speaking patients, particularly for colorectal cancer, which has a low rate of screening.
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Randomized Controlled Trial Multicenter Study
A randomized trial of telephonic counseling plus walking for depressed diabetes patients.
Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients' management of depressive symptoms, physical activity levels, and diabetes-related outcomes. ⋯ This program of telephone-delivered CBT combined with a pedometer-based walking program did not improve A1c values, but significantly decreased patients' blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients' functioning and quality of life.