Clinical Communication

Approaches to Enhancing Patient-Centered Communication In Caring For Hispanic/Latino Patients With Diabetes

Journal of Clinical Outcomes Management. 2018 March;25(3)

References

1. American Diabetes Association. American Diabetes Association Standards of Medical Care in Diabetes. Diabetes Care 2017; 40: Suppl 1.

2. Dominguez K, Penman-Aguilar A, Chang MH, et al. Vital signs: Leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States, 2009–2013. MMWR 2015;64:1–10.

3. Commission on Social Determinants of Heath. Closing the gap in a generation: health equity through action on the social determinants of health. Final report on the Commission on Social Determinants of Health. Geneva, World Health Organization. Accessed 10 Sept 2017 at http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf.

4. Laiterapong N, Fairchild PC, Chou CH, et al. Revisiting disparities in quality of care among US adults with diabetes in the era of individualized care, NHANES 2007-2010. Med Care 2015;53:25–31.

5. Vaccaro JA, Feaster DJ, Lobar SL, et al. Medical advice and diabetes self-management reported by Mexican-American, Black, and White-non-Hispanic adults across the United States. BMC Public Health 2012;12:185.

6. Correa-de-Araujo R, McDermott K, Moy E. Gender differences across racial and ethnic groups in quality of care for diabetes. Women Health Iss 2006;16:56–65.

7. Chawla N, Rodriguez MA, Babey SH, Brown ER. Health policy fact sheet: diabetes among Latinos in California; disparities in access and management. UCLA Center for Health Policy Research. Accessed 1 Aug 2017 at http://healthpolicy.ucla.edu/publications/Documents/PDF/Diabetes%20among%20Latinos%20in%20California%20Disparities%20in%20Access%20and%20Management.pdf.

8. Pu J, Chewning B. Racial differences in diabetes preventive care. Res Social Adm Pharm 2013;9:790–6.

9. Institute of Medicine. Unequal treatment: Confronting racial and ethnic disparities in healthcare. Washington, DC: National Academies Press; 2003.

10. Saha S, Arbeaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of care. Am J Public Health 2003;93:1713–9.

11. What is cultural and linguistic competence?: Definitions, February 2003. Agency for Healthcare Research and Quality, Rockville, MD. Accessed 28 Aug 2017 at http://www.ahrq.gov/pprofessionals/systems/primary -care/cultural-competence-mco/cultcompdef.html.

12. U.S. Department of Health and Human Services, Office of Minority Health. 2000. Assuring cultural competence in health care: Recommendations for National Standards and an outcomes-focused research agenda. Accessed 17 August 2017 at http://www.omhrc.gov/clas/finalpo.htm.

13. Zhao X. Relationships between sources of health information and diabetes knowledge in the US Hispanic population. Health Commun 2014;29:574–85.

14. Perchman ML, Flannagan D, Ferrer RL, Matamoras M. Communication compete c e, self-care behaviors, and glucose control in patients with type 2 diabetes. Patient Educ Couns 2009;77:55–9.

15. Reimann JOF, Talavera GA, Salmon M, et al. Cultural competence among physicians treating Mexican Americans who have diabetes: a structural model. Soc Sci Med 2004;59:2195–205.

16. Gordon HS, Gerber BS. What we’ve got here is a failure to communication. J Gen Intern Med 2011;26:104–6.

17. Gonzalez A, Salas D, Umpierrez GE. Special considerations on the management of Latino patients with type 2 diabetes mellitus. Curr Med Res Opin 2011;27:969–79.

18. Peek ME, Cargill A, Juang ES. Diabetes health disparities: A systematic review of health care interventions. Med Care Res Rev 2007;64(5 Supp):101S–156S.

19. Kutob RM, Bormanis J, Crago M, et al. Assessing culturally competent diabetes care with unannounced standardized patients. Fam Med 2013;45:400–8.

20. Weller SC, Baer RD, Garcia de Alba Garcia J, Salcedo Rocha AL. Are differences between patient and provider explanatory models of diabetes associated with patient self-management and glycemic control? J Health Care Poor Underserved 2013:24;1498–510.

21. Duta MJ. Communicating about culture and health: Theorizing culture-centered and cultural sensitivity approaches. Commun Theory 2007;17:304–28.

22. Concha JB, Mayer SD, Mezuk B, Avula D. Diabetes causation beliefs among Spanish speaking patients. Diabetes Educ 2015:42:116–25.

23. Arcury TA, Skelly AH, Gesler WM, et al. Diabetes meanings among those without diabetes: explanatory models of immigrant Latinos in rural North Carolina. Soc Sci Med 2004;59:2183–3.

24. Daniulaityte R. Making sense of diabetes: cultural models, gender and individual adjustment to type 2 diabetes in a Mexican community. Soc Sci Med 2004;59:1899–912.

25. Poss J, Jezewski MA. The role and meaning of susto in Mexican American’s explanatory model of type 2 diabetes. Med Anthropol Q 2002;16:360–77.

26. Weller SC, Baer RD, Pachter LM, et al. Latino beliefs about diabetes. Diabetes Care 1999;22:722–8.

27. United States Census Bureau. Language use. Accessed Sept 2017 at https://www.census.gov/topics/population/language-use/about.html.

28. Mezuk B, Albrecht S, Eaton WW, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care 2008;31:2383–90.

29. Li C, Ford ES, Strine TW, Mokdad AH. Prevalence of depression among US adults with diabetes. Diabetes Care 2007;31:105–7.

30. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2006;24:1069–78.

31. Li C, Barker L, Ford ES, et al. Diabetes and anxiety In US adults: findings from the 2006 Behavioral Risk Factor Surveillance System. Diabetes Med 2008;25:878–81.

32. Concha JB, Mezuk B, Duran B. Culture-centered approaches: the relevance of assessing emotional health for Latinos with type 2 diabetes. BMJ Open Diab Res Care 2015;3.

33. Bentancourt JR, Green AR, Carillo Je, Park ER. Cultural competence and health care: Key perspectives and trends. Health Affairs 2015;24:499–506.

34. Association of American Medical Colleges. Cultural Competence Education 2005. Accessed Feb 2016 at https://www.aamc.org/download/54338/data/.

35. Dobbie AE, Medrano M, Tysinger J, Olney C. The BELIEF Instrument: A preclinical teaching tool to elicit patients’ health beliefs. Family Med 2003;35:316–9.

36. Levin SJ, Like RC, Gottlieb JE. ETHNIC: A framework for culturally competent ethical practice. Patient Care 2003;34:188–9.

37. Stuart MR, Leibermann JR. The fifteen-minute hour: applied psychotherapy for the primary care physician. New York: Praeger.

38. Pace EJ, Somerville NJ, Enyoha C, et al. Effects of a brief psychosocial intervention on inpatient satisfaction: a randomized control trial. Fam Med 2017;49:675–8.

Medical Professional: (Empathy) Mrs. Chavez, that must have been very hard for you. I’m sorry you have had to feel this way. (Feelings) Is this how you feel everytime you visit your family?
Interpreter: Sra. Chávez, eso debe haber sido muy difícil para usted. Lamento que hayas tenido que sentirte de esta manera. ¿Es así como te sientes cada vez que visitas a tu familia?

Mrs. Chavez: Sí, todos se involucran en los problemas familiares y es muy estresante visitarlos, pero tengo que ir a ayudar a mi madre porque mi hermano está enfermo y no puede ayudarla. Soy el único que está cerca y mis otros hermanos discuten sobre lo que debería hacer. Tengo que estar ahí. Tengo que visitar.
Interpreter: Yes, everyone gets involved in the family problems and it is very stressful to visit but I have to go to help my mom because my brother is sick and can’t help her. I’m the only one close by and my other siblings argue about what I should do. I have to be there. I have to visit.

Medical Profesional: (Empathy) Yes, that must be very difficult for you. Okay, now I understand what is happening. Your visits are necessary but it seems like the stress is affecting your eating patterns and whether you remember to take your metformin. How do you feel if we come up with a plan for when you visit your family now that we know what might be causing your hypoglycemia? Do you think it is a good idea to take high glucose snacks or candy and have them with you on the trip so when you feel dizzy or faint you can eat them?
Interpreter: Sí, eso debe ser muy difícil para ti. De acuerdo, ahora entiendo lo que está pasando. Sus visitas son necesarias, pero parece que el estrés está afectando sus patrones de alimentación y si recuerda tomar su metformina. ¿Cómo se siente si elaboramos un plan para su familia ahora que sabemos lo que podría estar causando su hipoglucemia? ¿Cree que es una buena idea tomar refrigerios con alto contenido de glucosa o dulces y llevarlos consigo durante el viaje para que cuando se sienta mareado o desmayado pueda comerlos?

Mrs. Chavez: Sí, por supuesto. Ni siquiera me di cuenta de eso hasta ahora que hablamos sobre eso. Tienes razón, no he estado comiendo bien cuando lo visito. Me siento terrible cuando estoy allí como si quisiera desmayarme.
Interpreter: Yes of course. I didn’t even really realize that until now that we talked about it. You are right, I haven’t been eating right when I visit. I feel terrible when I am there like I want to faint.

Medical Professional: Mrs. Chavez, sometimes it is helpful to talk about our stress and problems we encournter in life, just to talk through it. Is this something you would be interested in? If so, we can arrange for you to come talk to the social worker.
Interpreter: Sra. Chavez, a veces es útil hablar sobre nuestro estrés y los problemas que alegramos en la vida, solo para hablar sobre ello. ¿Esto es algo que te interesaría? Si tu quieres, podemos hacer arreglos para que vengas a hablar con el trabajador social.

Mrs. Chavez: Tal vez, no estoy seguro, pero tal vez
Interpreter: Maybe, I’m not sure but maybe.

Medical Professional: Okay, you let me know if this is something you would like to do. You can call and let us know and I’ll ask again during our next visit and see how you are dealing with the stress when you visit your family.
Interpreter: De acuerdo, dime si esto es algo que te gustaría hacer. Puede llamar y dejarnos saber, y volveré a preguntar durante nuestra próxima visita y verá cómo lidia con el estrés cuando visita a su familia.

ETHNIC

The ETHNIC interviewing tool (Levin SJ 2000) can be used to explore cross cultural issues and facilitate collaboration during clinical encounters and is designed for clinical students or health professionals permitted to diagnose and provide therapeutic interventions [36]. The specific questions corresponding to the ETHNIC prompts:

E: Explanation (How do you explain your illness?)
T: Treatment (What treatment have you tried?)
H: Healers (Have you sought any advice from folk healers?)
N: Negotiate (mutually acceptable options)
I: Intervention (agreed on)
C: Collaboration (with patient, family, and healers)