What is the key to culturally competent care: Reducing bias or cultural tailoring?

Objective: To gain a better understanding as to whether disparities in patient–provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently.

Method: African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10.

Results: Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients’ needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians.

Conclusion: Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians’ patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.     

Stigma and Psychological Distress in People With HIV/AIDS

Using a community sample of 197 people living with HIV/AIDS, we examined how awareness of societal stigma (felt stigma) and negative feelings toward oneself as a member of a stigmatized group (self-stigma) are related to psychological well-being. Both felt stigma and self-stigma were significantly correlated with symptoms of depression and anxiety, but controlling for felt stigma reduced self-stigma's association with depressive symptoms to nonsignificance. Global self-esteem and social avoidance fully mediated the associations between self-stigma and distress but only partially mediated the associations between felt stigma and distress. Felt stigma mediated the relationship between distress and HIV-related changes in physical appearance.     

Editorial

Social Psychology of Education -     

Editorial

Social Psychology of Education -     

Author Index,Volume 7

Author Index

Author Index, Volume 7