Abstract

Objectives

The purpose of this study was to determine the relationship between discrimination in healthcare settings and psychological distress.

Method

This study utilized a retrospective cross-sectional study design. The dataset was obtained from 2015-2017 California Health Interview Survey (CHIS). Healthcare discrimination experience (yes, no) was measured using the following question “Over your entire lifetime, how often have you been treated unfairly when getting medical care (never, rarely, sometimes, often)?”. Psychological distress was the study outcome and was measured using the Kessler Psychological Distress Scale. A composite score (0-24) was created for psychological distress for the prior 30 days and for the worse most in the past 12 months. A hierarchical multivariate linear regression was conducted to examine the influence of healthcare discrimination experience on psychological distress after adjusting for other covariates.

Results

Study participants (weighted N = 1,360,487) had a mean age of 64.35 years (SD = 0.61), were primarily female (54.93%), heterosexual (96.61%), and married or living with a partner (73.37%). About 10.00% of older Asian Americans ever perceived healthcare discrimination over their entire lifetime. Perceived discrimination was associated with higher levels of psychological distress for the past 30 days (beta= 2.107, SE = 0.662, p < 0.05) and for the worst month in the past year (beta= 2.099, SE = 0.697, p < 0.05) after controlling for covariates.

Conclusion

Self-reported discrimination was relatively low in this sample of older Asian American adults. However, consistent with prior research, perceived discrimination in the healthcare setting was associated with increased psychological distress. The findings have implications for improving the quality of health care services received.

中文翻译：

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医疗保健环境中感知歧视对不同年龄亚裔美国人心理困扰的影响

摘要

目标

本研究的目的是确定医疗保健环境中的歧视与心理困扰之间的关系。

方法

本研究采用回顾性横断面研究设计。该数据集来自 2015-2017 年加州健康访谈调查 (CHIS)。医疗保健歧视经历（是，否）是通过以下问题衡量的：“在你的一生中，你在接受医疗护理时有多少次受到不公平对待（从不、很少、有时、经常）？”。心理困扰是研究结果，并使用凯斯勒心理困扰量表进行测量。综合评分 (0-24) 是针对过去 30 天的心理困扰和过去 12 个月中最糟糕的心理困扰创建的。进行了分层多元线性回归，以检查在调整其他协变量后，医疗保健歧视经历对心理困扰的影响。

结果

研究参与者（加权 N = 1,360,487）的平均年龄为 64.35 岁 (SD = 0.61)，主要是女性 (54.93%)、异性恋 (96.61%) 以及已婚或与伴侣同住 (73.37%)。大约 10.00% 的年长亚裔美国人在其一生中曾感受到医疗保健歧视。在过去 30 天（beta = 2.107，SE = 0.662，p < 0.05）和过去一年中最糟糕的月份（beta = 2.099，SE = 0.697，p < 0.05），感知到的歧视与更高水平的心理困扰有关控制协变量后。

结论

在这个年长的亚裔美国成年人样本中，自我报告的歧视相对较低。然而，与之前的研究一致，在医疗保健环境中感知到的歧视与心理压力增加有关。调查结果对提高所接受的医疗保健服务的质量具有重要意义。