Journal of general internal medicine
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Interpersonal care (IPC) is increasingly emphasized as health care systems focus on implementing patient-centered care. Language barriers may be a particularly important influence on IPC ratings among rural Spanish-speaking Latinos. ⋯ This study provides evidence that language concordance is independently associated with high IPC scores in rural Latino adults with diabetes. Moreover, this study suggests that language concordance may contribute to improved participation diabetes self-care activities.
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There is limited information on depression in Haitians and this is partly attributable to the absence of culturally and linguistically adapted measures for depression. ⋯ There is strong evidence for the psychometric adequacy of the translated PHQ-9 screening tool as a measure of depression with MSM in Haiti. Future research is necessary to examine the predictive validity of depression for subsequent health behaviors or clinical outcomes among Haitian MSM.
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Observational Study
Perceived discrimination, patient trust, and adherence to medical recommendations among persons with sickle cell disease.
Adults with sickle cell disease (SCD) report experiencing discriminatory behavior from some healthcare providers. The impact of discrimination on health outcomes in SCD, including adherence to physician recommendations, is not known. ⋯ SCD patient perceptions of discriminatory experiences from healthcare providers are associated with greater nonadherence to physician recommendations, and may be a potential factor contributing to disparities in health and health quality among this patient population. Perceived discrimination appears to affect adherence behaviors through the pathway of patient trust. Improving relationships between healthcare providers and SCD patients may improve the trust that SCD patients have in medical professionals, which in turn may improve other outcomes among this underserved patient population.
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Financial exploitation is the most common and least studied form of elder abuse. Previous research estimating the prevalence of financial exploitation of older adults (FEOA) is limited by a broader emphasis on traditional forms of elder mistreatment (e.g., physical, sexual, emotional abuse/neglect). ⋯ One-year period FEOA prevalence was 2.7% (95% CI, 2.29-3.29) and lifetime prevalence was 4.7% (95% CI, 4.05-5.34). Greater relative risk (RR) of one-year period prevalence was associated with African American/black race (RR, 3.80; 95 % CI, 1.11-13.04), poverty (RR, 1.72; 95 % CI, 1.09-2.71), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.06-1.27), and ≥ 1 instrumental activity of daily living (IADL) impairments (RR, 1.69; 95 % CI, 1.12-2.53). Greater RR of lifetime prevalence was associated with African American/black race (RR, 2.61; 95 % CI, 1.37-4.98), poverty (RR, 1.47; 95 % CI, 1.04-2.09), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.12-1.21), and having ≥1 IADL (RR, 1.45; 95 % CI, 1.11-1.90) or ≥1 ADL (RR, 1.52; 95 % CI, 1.06-2.18) impairment. Living with a spouse/partner was associated with a significantly lower RR of lifetime prevalence (RR, 0.39; 95 % CI, 0.26-0.59) CONCLUSIONS: Financial exploitation of older adults is a common and serious problem. Elders from groups traditionally considered to be economically, medically, and sociodemographically vulnerable are more likely to self-report financial exploitation.
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We employed a partnered research healthcare delivery redesign process to improve care for high-need, high-cost (HNHC) patients within the Veterans Affairs (VA) healthcare system. ⋯ Employing partnered research to redesign care for high-need, high-cost patients may expedite development and dissemination of high-value, cost-saving interventions.