OBJECTIVES Negative health care encounters have psychological and behavioral consequences for patients, particularly for minority and low socioeconomic populations. Guided by an integrative model of culture, psychological processes, and health behavior, this study examined whether provider cultural competence reduces the emotional and behavioral consequences of negative health care encounters among Latina and non-Latino White American women in the United States. METHOD A total of 335 women participated in the study, of which 236 (Latina = 112; non-Latino White = 124) reported at least one negative health care encounter during a preventive medical screening exam. Structural equation causal modeling was used to examine whether provider cultural competence, as perceived by the patient, influenced emotions associated with negative health care encounters and subsequent medical avoidance. RESULTS When both Latina and non-Latino White American patients perceived their provider to be higher in cultural competence, they experienced less shame and embarrassment related to the negative encounter. Lower levels of shame and embarrassment in turn, predicted less medical avoidance for Latina, but not non-Latino White American women. CONCLUSIONS Findings revealed that provider cultural competence reduces some of the consequences of negative health care encounters that are relevant to health behavior. These findings shed light on the complexity of how providers' cultural competence impacts patient behavior, highlighting the importance of including psychological variables when investigating the role of cultural competence in health behavior and outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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卫生专业人员的文化能力可以减少负面医疗保健遭遇的心理和行为影响。

目标负面的医疗保健遭遇会对患者，尤其是少数族裔和低社会经济人口的患者产生心理和行为后果。在文化，心理过程和健康行为的综合模型的指导下，本研究调查了提供者的文化能力是否降低了美国拉丁裔和非拉丁裔美国白人妇女在负面卫生保健方面的负面情绪和行为后果。方法共有335名妇女参加了该研究，其中236名（拉丁裔= 112；非拉丁裔白人= 124）报告了在预防性医学筛查考试中至少遇到了一次负面保健遭遇。结构方程式因果模型用于检查患者所感知的提供者文化能力，与消极的医疗保健遭遇以及随后的医疗回避相关的情绪影响。结果当拉丁美洲人和非拉丁美洲人的美国白人患者都认为其提供者的文化能力较高时，他们所经历的与消极遭遇有关的耻辱和尴尬将减少。反过来，羞耻感和尴尬程度的降低则预示着拉丁裔女性的医疗回避减少，但非拉丁裔美国白人女性则没有。结论研究结果表明，提供者的文化能力减少了与健康行为有关的负面医疗保健遭遇的一些后果。这些发现揭示了提供者的文化能力如何影响患者行为的复杂性，强调在调查文化能力在健康行为和结果中的作用时，包括心理变量的重要性。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。