Table Of Content

AFRICANAMERICANPATIENTS'LEVELOFACCULTURATION,PERCEIVED CULTURALSENSITIVITY,ANDSATISFACTIONWITHHEALTHCARE By TODD WALTER J. DISSERTATIONPRESENTEDTOTHEGRADUATESCHOOLOFTHE UNIVERSITYOFFLORIDAINPARTIALFULFILLMENTOFTHE REQUIREMENTSFORTHEDEGREEOF DOCTOROFPHILOSOPHY UNIVERSITYOFFLORIDA 2001 Formywife,LoraAnnWalter,whosefriendship,support,assistance, andunconditionallovemadethisachievementpossible. ACKNOWLEDGMENTS IwouldfirstliketoacknowledgeDr.CarolynM.Tucker,mycommitteechair, andtheBehavioralMedicineResearchTeamwithintheDepartmentofPsychologyfor theireffortandsupportinthecompletionofthisproject.Iwouldalsoliketothankallof thefacultyandfellowstudentswhohaveenrichedmypersonalandprofessional developmentduringmygraduatestudyattheUniversityofFlorida.Iamespecially indebtedtotheArndtfamilyandMr.JosephLynchfortheircontinuedsupport, friendship,andhospitalityinthecompletionofthisproject. IwouldliketoextendmymostsincereappreciationtothestaffoftheSyracuse VAMedicalCenterwithoutwhoseassistancethisresearchprojectwouldnothavebeen possible.IwouldespeciallyliketothankDr.RobertSprafkinforhissupervision, support,andtremendousassistanceincarryingoutthisproject.Iwouldalsoliketo extendmysinceregratitudetoDr.LarryLantingaforhissupportandassistanceinthe approvalandfundingofthisinvestigation.IwouldliketothankMr.OdieFreeman,the MinorityVeteransCoordinatorattheSyracuseVAMedicalCenter,forhissupportand assistanceincompletingthisproject.Last,butnotleast,Iwouldliketothankthe AfricanAmericanveteransfromtheVAMedicalCenterinSyracuse,NewYork.Not onlyamIgratefulforthesacrificesthattheyhavemadeforourcountry,butIam indebtedtothemforentrustingmeandparticipatinginthisproject. iii TABLEOFCONTENTS page ACKNOWLEDGMENTS iii ABSTRACT vi CHAPTERS 1 INTRODUCTION 1 StatementoftheProblem 1 NeedfortheStudy 6 PurposeandHypothesesofThisInvestigation 8 2 REVIEWOFTHELITERATURE 10 PatientSatisfaction 10 WhatIsPatientSatisfactionandHowIsItStudied? 10 NeedforStudyingPatientSatisfaction 13 SatisfiedPatientsasHealthCareConsumers 14 PatientSatisfactionandHealthStatus/Outcomes 15 SociodemographicCharacteristicsAssociatedwithPatientSatisfaction 17 PatientSatisfactionamongAfricanAmericanPatients 19 CulturalSensitivityinProvidingHealthCare 23 ProvidingCulturallySensitiveHealthCare 26 RelationshipsamongCulturallySensitiveHealthCare,PatientSatisfaction, andHealthOutcomes 30 CulturalSensitivityandPatients'SociodemographicCharacteristics 37 Acculturation 39 AcculturationandHealthOutcomes/PatientSatisfaction 41 AcculturationandthePerceptionofCulturalSensitivityinHealthCare Received 45 AcculturationandPatientSociodemographicCharacteristics 48 HealthCareProviders'DemographicVariablesandPatientSatisfaction andPerceivedCulturalSensitivity 50 HealthCareandAfricanAmericanVeteranPatients 53 iv 3 METHODOLOGY 59 Participants 59 Instruments 61 Procedure 70 PhaseI:RecruitmentofParticipants 70 PhaseII:CollectionofData 73 4 RESULTS 76 DescriptiveStatisticsfortheMajorResearchVariables 76 PreliminaryCorrelationalAnalyses 77 AnalysisofHypotheses1,2,and3 80 MultipleRegressionAnalysisofHypothesis4 82 AnalysesofResearchQuestions1and2 83 5 DISCUSSION 90 SummaryandInterpretationofResults 91 LimitationsofStudy 106 ImplicationsforFutureResearch 110 ImplicationsforPsychologists 113 ImplicationsforHealthCareProviders 114 Conclusion 115 APPENDICES A PATIENTDEMOGRAPHICDATAQUESTIONNAIRE 117 B AFRICANAMERICANACCULTURATIONSCALE-REVISED 119 C PATIENTSATISFACTIONQUESTIONNAIRESHORT-FORM 122 D TUCKERCULTURALLYSENSITIVEHEALTHCAREINVENTORYFOR AFRICANAMERICANS 124 E PATIENTCOVERLETTERFROMVAMINORITYVETERANS COORDINATOR 133 F PATIENTINVITATIONCOVERLETTER 134 REFERENCES 136 BIOGRAPHICALSKETCH 146 v AbstractofDissertationPresentedtotheGraduateSchooloftheUniversityofFloridain PartialFulfillmentoftheRequirementsfortheDegreeofDoctorofPhilosophy AFRICANAMERICANPATIENTS'LEVELOFACCULTURATION,PERCEIVED CULTURALSENSITIVITY,ANDSATISFACTIONWITHHEALTHCARE By ToddJ.Walter August2001 Chair:CarolynM.Tucker,Ph.D. MajorDepartment:DepartmentofPsychology ThisstudyexaminedAfricanAmericanveteranpatients'levelofacculturation, levelofperceivedculturalsensitivityinhealthcarereceived,andlevelofsatisfaction withhealthcarereceived.Anassessmentbattery,consistingofthefollowing instruments,wasadministeredbymailto106maleAfricanAmericanveteranswho receivedoutpatientprimaryhealthcareservicesattheSyracuseVAMedicalCenter:(1) ThePatientSatisfactionQuestionnaireShort-Form(PSQ-18);(2)TheTuckerCulturally SensitiveHealthCareInventoryforAfricanAmericans(T-CUSCHI-AA);(3)The AfricanAmericanAcculturationScale-Revised(AAAS-R);(4)TheMarlowe-Crowne SocialDesirabilityScale-ShortForm[M-C(20)];and(5)ADemographic Questionnaire. Resultsshowedthatpatients'perceptionsoftheirhealthcareproviders'levelof culturalsensitivitywasstronglyandpositivelyassociatedwithpatients'reported satisfactionwithhealthcarereceived.Patients'levelofperceivedculturalsensitivity vi withhealthcarereceivedandwhetherpatientswererequiredtopayfortheirhealthcare weresignificantpredictorsoftheirsatisfactionwithhealthcarereceivedsuchthathigher satisfactionwasassociatedwithgreaterperceivedculturalsensitivityinhealthcare receivedandnotbeingrequiredtopayforhealthcarereceived.Highersatisfactionwas alsoassociatedwithpatientsbeingolderandoflowerincome;andperceivedcultural sensitivityinhealthcarereceivedwasassociatedwithpatientsbeingolderandless educated.Patients'levelofacculturationwasnotsignificantlyassociatedwitheither patients'perceptionsofthelevelofculturalsensitivityinhealthcarereceivedor patients'reportsofsatisfactionwithhealthcarereceived.Finally,resultsofa MANCOVAshowednosignificantdifferencesinpatients'satisfactionorperceived culturalsensitivityinhealthcarereceivedasafunctionoftheirhealthcareproviders' gender.However,patientswithethnicminority,butnotAfricanAmerican,healthcare providersperceivedtheirproviderstobelessculturallysensitivethandidpatientswith Caucasianhealthcareproviders.Theimplicationsofthisresearchforthetrainingof physiciansintheprovisionofculturallysensitivehealthcare,therolethatpsychologists canplayinhealthcaresettings,thelimitationsofthisstudy,andsuggestionsforfuture researcharediscussed. vii CHAPTER 1 INTRODUCTION StatementoftheProblem Withtheonsetofthe21stcentury,physiciansandotherhealthcareprovidersin theUnitedStatesarefacedwiththetremendouschallengeofprovidinghealthcare servicestoanincreasinglyculturallydiversepopulation.RecentestimatesbytheUnited StatesDepartmentofCommerce,BureauofCensus(2000)projected9%population growthintheUnitedStatesbetween1990and2000.AlthoughCaucasianAmericans stillaccountforthelargestpopulationgroupbyraceintheUnitedStates,their populationgrowthduringthislastdecadewasamere4%.TheUnitedStatesCensus Bureau'sstatisticsshowthatgreaterprojectedpopulationincreasesmaybefoundamong America'sethnicminoritygroups.Specifically,duringthedecadefrom1990to2000, theUnitedStatesNativeAmericanpopulationgrewbyaprojected15%,theUnited StatesHispanicpopulationgrewbyaprojected30%,andtheUnitedStatesAsian populationgrewbyaprojected33%.Moreover,giventhatthepopulationofAfrican Americancitizensgrewanestimated13%overthelastdecadesuchthattheycomprise nearly13%ofthenation'spopulation,itisprobablynotsurprisingthatCaucasian Americansarepredictedtobeintheminority,demographicallyspeaking,bytheyear 2056(May,1992). WithAmericaincreasinglyassumingamulti-ethnicandmulti-racialidentity, statisticssuchasthesestronglysupporttheneedtoprovideculturallysensitivehealth 1 2 caretomeettheneedsofanincreasinglyculturallydiversepopulation.Unfortunately, currentevidencesuggeststhatethnicminoritygroupssuchasAfricanAmericansdonot enjoythesamelevelofhealthstatusastheirCaucasianAmericanpeers,afindingthat maybepartlyattributabletoculturaldifferences. Forinstance,AfricanAmericansandotherracially/ethnicallynon-majority personshistoricallyhavebeenunderservedbyhealthcareworkersandinstitutionsinthe UnitedStates(Brookins,1993).CurrentdifferencesbetweenAfricanAmericanand CaucasianAmericanpatientsinboththeavailabilityofhealthcareandtheoutcomes associatedwithhealthcaredeliveryremainquitenotable.EvidenceshowsthatAfrican AmericanpatientshavethehighestmortalityrateforcancerofanyUnitedStates populationgroup;andthattheyhavesignificantlyhighermortalityratesfor hypertension,heartdisease,cirrhosis,anddiabetesthanCaucasianAmericans (CommonwealthFund,1999;Loue,1999).Moreover,theaveragelifeexpectancyof AfricanAmericansisapproximately6yearslessthantheaverageforCaucasian Americans(Anderson,1991;Loue,1999). Giventheabovedisparitiesinhealth-relatedoutcomesbetweenCaucasian AmericansandAfricanAmericans,suchfindingsbegthequestion,"Whataccountsfor thesedisparitiesinhealthstatus?"Theanswertothismaylieinresearchshowingthat thefailuretoseekpreventivehealthcareortoadheretoprescribedmedicaltreatment plans(e.g.,toadheretomedicalregimens,attendfollow-upvisits,etc.)isfrequently associatedwithnegativehealthcareoutcomesinpatients(Brookins,1993;Harris,Luft, Rudy,&Tierney,1995;Levy,1985;Loue,1999).Thatis,AfricanAmericansandother ethnicminoritymembersmaybemorepronethanCaucasianAmericanstounderuse 3 healthcare(Brookins,1993).Suchatendencytounderusehealthcaremaythus predisposeAfricanAmericansandsimilarethnicminoritiestoexperiencehigher morbidityandmortalityrates. AcommonattributionforAfricanAmericans'underuseofhealthcare istheirlackofaccesstoavailablemedicalhealthresources.Thatis,AfricanAmerican andotherethnicminoritiesmaynothaveadequatehealthresourcesinproximityto wheretheylive.Likewise,giventhatethnicminoritiesareover-representedinlow socioeconomicstatus(Levy,1985),andthatethnicminoritypersonssuchasAfrican AmericansaremorelikelytolackhealthinsurancerelativetoCaucasianAmericans (Lieberman,Stoller,&Burg,1997),ethnicminoritygroupmemberssuchasAfrican Americansmaynotbeabletopursuemedicalcarewhenitisavailabletothem. Althoughitisundeniablethataccesstoappropriatehealthservicescontributestothe disparityinuseofhealthcareservicesbetweenAfricanAmericansandCaucasian Americans,researchshowsthatthesedifferencesstillexistevenwhenfinancial incentives(e.g.,healthinsurance)havebeenadjustedfor(Loue,1999). AnotherreasonforAfricanAmericans'underuseofhealthcareservicesmaylie inthedisparitybetweenAfricanAmericanpatients'health-relatedbeliefs,values,and practices;andthoseespousedbyAmericanhealthcareprofessionals.Thatis,evenunder circumstanceswhenappropriatehealthcareisavailableandaccessibletoethnicminority persons,suchpersonsmayperceivethehealthcarethattheyreceiveasunacceptableand incongruentwiththeirculturalbeliefsandpractices.ThismaybethecaseforAfrican Americans,whohavehistoricallyhadtheirculturalbeliefs,practices,andtraditions ignoredbycliniciansandresearchersalike.IthasbeensuggestedthatmanyAfrican

ebook img

African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care PDF

155 Pages·2001·5.6 MB·English
by  Walter, Todd J
#americana #univ_florida_smathers #UFRDS
Save to my drive
Quick download
Download

Download African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care PDF Free - Full Version

by Walter, Todd J| 2001| 155 pages| 5.6| English

Download African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care by Walter, Todd J in PDF format completely FREE. No registration required, no payment needed. Get instant access to this valuable resource on PDFdrive.to!

Free Download PDF

About African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care

No description available for this book.

Detailed Information

Author:Walter, Todd J
Publication Year:2001
Pages:155
Language:English
File Size:5.6
Format:PDF
Price:FREE
Download Free PDF

Safe & Secure Download - No registration required

Why Choose PDFdrive for Your Free African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care Download?

  • 100% Free: No hidden fees or subscriptions required for one book every day.
  • No Registration: Immediate access is available without creating accounts for one book every day.
  • Safe and Secure: Clean downloads without malware or viruses
  • Multiple Formats: PDF, MOBI, Mpub,... optimized for all devices
  • Educational Resource: Supporting knowledge sharing and learning

Free Books Similar to African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care

Frequently Asked Questions

Is it really free to download African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care PDF?

Yes, on https://PDFdrive.to you can download African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care by Walter, Todd J completely free. We don't require any payment, subscription, or registration to access this PDF file. For 3 books every day.

How can I read African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care on my mobile device?

After downloading African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care PDF, you can open it with any PDF reader app on your phone or tablet. We recommend using Adobe Acrobat Reader, Apple Books, or Google Play Books for the best reading experience.

Is this the full version of African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care?

Yes, this is the complete PDF version of African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care by Walter, Todd J. You will be able to read the entire content as in the printed version without missing any pages.

Is it legal to download African American patients' level of acculturation, perceived cultural sensitivity, and satisfaction with health care PDF for free?

https://PDFdrive.to provides links to free educational resources available online. We do not store any files on our servers. Please be aware of copyright laws in your country before downloading.

The materials shared are intended for research, educational, and personal use in accordance with fair use principles.

We use cookies

We use cookies to ensure you get the best browsing experience on our website. By clicking "Accept Cookies", you agree that we can store cookies on your device in accordance with our Terms and Privacy.