Organizing patient-centeredness: The Hispanic prenatal care patient
Abstract
Although the Agency for Healthcare Research and Quality (2006) has found that the quality of health care has been improving and disparities narrowing for many minority group members in the United States, the opposite is the case for Hispanics. What is particularly alarming are recent statistics with regard to patient-centeredness for members of this population. Indeed, the extent to which care is perceived as being patient-centered is an area in which disparities between Hispanics and the rest of the U.S. citizenry have been widening (Agency for Healthcare Research and Quality, 2006). For instance, according to a study reported by the Agency for Healthcare Research and Quality (2005), a central component of patient-centered care, the quality of patient-provider communication as reported by patients, declined among Hispanic adults from 2000-2002. This dissertation bridges organizational and health communication literatures and explores the experiences Hispanic American women have had with prenatal health care delivery at a hospital in the United States. The study investigated what meanings patient-centeredness (and its various dimensions such as patient-provider communication) has for these women, and how those meanings might differ from those of health organizations, providers, or scholars. Drawing on organizational communication theory and notions of patient-centeredness, this project also sought to enhance what is known about the organizational constraints and institutional discourses surrounding Hispanic women's access to and experience with prenatal care. Interviews with the patients revealed five key areas that reflect their expectations and desires for the type of care they receive (in order of importance/frequency): (a) being friendly "amable",(b) giving thorough and effective medical care, (c) having Spanish-speaking individuals available, (d) having patience, (e) explaining information well for comprehension, and (f) eliminating racism. For providers, definitions of patient-centered care aligned more closely with governmental and academic discourses, and they emphasized enabling and empowering patients to participate and be more actively involved in their own healthcare. The preferred communication medium for receiving health information for the patients was first and foremost orally/verbally. Other information needs and patient preferences were additionally explored and recommendations made based on the findings.
Degree
Ph.D.
Advisors
Connaughton, Purdue University.
Subject Area
Medicine|Health care management
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