Racial disparities in clinician responses to patient emotions |
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| Affiliation: | 1. Johns Hopkins University School of Medicine, Baltimore, MD, USA;2. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;3. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA;4. Department of Medicine, Oregon Health and Science University, Portland, OR, USA;5. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA;1. RTI International, Research Triangle Park, NC, USA;2. US Food and Drug Administration, Silver Spring, MD, USA;1. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA;2. Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA;3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA;1. College of Nursing, University of South Carolina, Columbia, USA;2. School of Medicine, University of South Carolina, Columbia, USA;1. Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l’Éducation, Brussels, Belgium;2. Institut Jules Bordet, Clinique de Psycho-Oncologie, Université Libre de Bruxelles, Brussels, Belgium;3. Hôpital Universitaire Erasme, Service de Psychologie, Brussels, Belgium;4. Centre de Psycho-Oncologie, Brussels, Belgium;5. Université Catholique de Louvain, Faculté de Médecine, Brussels, Belgium;1. Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland;2. International Breast Cancer Study Group (IBCSG), Bern, Switzerland;3. Swiss Cancer League, Division Follow-up Care, Bern, Switzerland;4. Nursing Science, University of Basel, Basel, Switzerland;5. Women’s Hospital, University Hospital Basel, Basel, Switzerland;6. Patient Advocates for Cancer Research and Treatment (Association PACRT), Geneva, Switzerland;1. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA;2. Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. #822, Chicago, IL, USA;3. Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA;4. General Internal Medicine, Icahn School of Medicine, Mount Sinai Hospital, 17 E 102nd St, 7th Floor, New York, NY, USA |
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| Abstract: | ObjectiveIn a previous study of patients newly enrolled in HIV care, we observed that clinicians were less likely to address emotional issues expressed by African-American patients compared to whites. We sought to verify and expand these findings in a larger group of patients established in HIV care.MethodsWe used VR-CoDES to analyze transcripts from 342 audio-recorded medical visits in the United States. We used random intercept multilevel logistic regression to assess associations between patient and clinician characteristics and patterns of emotional talk.ResultsAfrican-American patients were less likely than others to spontaneously express emotions (OR 0.50; 95 % CI 0.29−0.85). Clinicians, who were predominantly white, were more likely to respond to emotional expressions by African-American patients explicitly (OR 1.56; 95 % CI 1.11–2.20) but less likely to offer neutral/passive responses that provide space for emotional conversation (OR 0.56; 95 % CI 0.37−0.84) and more likely to block discussion of the emotional issue (OR 2.20; 95 % CI 1.05–4.63). Emotional talk did not vary by patient age or gender.ConclusionThese results confirm our prior findings, demonstrating less open emotional communication between African-American patients and their providers.Practice ImplicationsAddressing racial differences in communicating about emotions may reduce disparities in patient-clinician relationships. |
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| Keywords: | Health disparities Patient-Provider communication Emotion HIV |
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