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Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research 6/2014

01.11.2014 | Original Article

Primary Health Care Experiences of Hispanics with Serious Mental Illness: A Mixed-Methods Study

verfasst von: Leopoldo J. Cabassa, Arminda P. Gomes, Quisqueya Meyreles, Lucia Capitelli, Richard Younge, Dianna Dragatsi, Juana Alvarez, Andel Nicasio, Benjamin Druss, Roberto Lewis-Fernández

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 6/2014

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Abstract

This mixed-methods study examines the primary health care experiences of Hispanic patients with serious mental illness. Forty patients were recruited from an outpatient mental health clinic. Participants reported a combination of perceived discrimination and stigmatization when receiving medical care. They rated the quality of chronic illness care as poor and reported low levels of self-efficacy and patient activation. These indicators were positively associated with how patients viewed their relationships with primary care providers. A grounded model was developed to describe the structural, social, and interpersonal processes that shaped participants’ primary care experiences.
Literatur
Zurück zum Zitat Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs, 29(5), 867–873.PubMedCrossRef Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs, 29(5), 867–873.PubMedCrossRef
Zurück zum Zitat Aragones, A., Schaefer, E. W., Stevens, D., Gourevitch, M. N., Glasgow, R. E., & Shah, N. R. (2008). Validation of the Spanish translation of the patient assessment of chronic illness care (PACIC) survey. Preventing Chronic Disease, 5(4), A113.PubMedPubMedCentral Aragones, A., Schaefer, E. W., Stevens, D., Gourevitch, M. N., Glasgow, R. E., & Shah, N. R. (2008). Validation of the Spanish translation of the patient assessment of chronic illness care (PACIC) survey. Preventing Chronic Disease, 5(4), A113.PubMedPubMedCentral
Zurück zum Zitat Borba, C. P., Depadilla, L., McCarty, F. A., von Esenwein, S. A., Druss, B. G., & Sterk, C. E. (2012). A qualitative study examining the perceived barriers and facilitators to medical healthcare services among women with a serious mental illness. Womens Health Issues, 22(2), e217–224. doi:10.1016/j.whi.2011.10.001.PubMedCrossRef Borba, C. P., Depadilla, L., McCarty, F. A., von Esenwein, S. A., Druss, B. G., & Sterk, C. E. (2012). A qualitative study examining the perceived barriers and facilitators to medical healthcare services among women with a serious mental illness. Womens Health Issues, 22(2), e217–224. doi:10.​1016/​j.​whi.​2011.​10.​001.PubMedCrossRef
Zurück zum Zitat Cabassa, L. J., Hansen, M. C., Palinkas, L. A., & Ell, K. (2008). Azucar y nervios: Explanatory models and treatment experiences of Hispanics with diabetes and depression. Social Science and Medicine, 66(12), 2413–2424.PubMedCrossRefPubMedCentral Cabassa, L. J., Hansen, M. C., Palinkas, L. A., & Ell, K. (2008). Azucar y nervios: Explanatory models and treatment experiences of Hispanics with diabetes and depression. Social Science and Medicine, 66(12), 2413–2424.PubMedCrossRefPubMedCentral
Zurück zum Zitat Creswell, J. W. (2003). Research design: Qualitative, quantitative and mixed methods approaches (2nd ed.). Thousand Oaks, CA: Sage Publications. Creswell, J. W. (2003). Research design: Qualitative, quantitative and mixed methods approaches (2nd ed.). Thousand Oaks, CA: Sage Publications.
Zurück zum Zitat Druss, B. G. (2007). Improving medical care for persons with serious mental illness: Challenges and solutions. Journal of Clinical Psychiatry, 68(Suppl 4), 40–44.PubMed Druss, B. G. (2007). Improving medical care for persons with serious mental illness: Challenges and solutions. Journal of Clinical Psychiatry, 68(Suppl 4), 40–44.PubMed
Zurück zum Zitat Druss, B. G., von Esenwein, S. A., Compton, M. T., Rask, K. J., Zhao, L., & Parker, R. M. (2010). A randomized trial of medical care management for community mental health settings: The primary care access, referral, and evaluation (PCARE) study. American Journal of Psychiatry, 167(2), 151–159.PubMedCrossRefPubMedCentral Druss, B. G., von Esenwein, S. A., Compton, M. T., Rask, K. J., Zhao, L., & Parker, R. M. (2010). A randomized trial of medical care management for community mental health settings: The primary care access, referral, and evaluation (PCARE) study. American Journal of Psychiatry, 167(2), 151–159.PubMedCrossRefPubMedCentral
Zurück zum Zitat Druss, B. G., & Walker, E. R. (2011). Mental disorders and medical comorbidity. Syntheis Project: Research Synthesis Report, 21, 1–26. Druss, B. G., & Walker, E. R. (2011). Mental disorders and medical comorbidity. Syntheis Project: Research Synthesis Report, 21, 1–26.
Zurück zum Zitat Druss, B. G., Zhao, L., Von Esenwein, S., Morrato, E. H., & Marcus, S. C. (2011). Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Medical Care, 49(6), 599–604. doi:10.1097/MLR.0b013e31820bf86e.PubMedCrossRef Druss, B. G., Zhao, L., Von Esenwein, S., Morrato, E. H., & Marcus, S. C. (2011). Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Medical Care, 49(6), 599–604. doi:10.​1097/​MLR.​0b013e31820bf86e​.PubMedCrossRef
Zurück zum Zitat Escobar, J. I., Burnam, M. A., Karno, M., Forsythe, A., & Golding, J. M. (1987). Somatization in the community. Archives of General Psychiatry, 44, 713–718.PubMedCrossRef Escobar, J. I., Burnam, M. A., Karno, M., Forsythe, A., & Golding, J. M. (1987). Somatization in the community. Archives of General Psychiatry, 44, 713–718.PubMedCrossRef
Zurück zum Zitat Frosch, D. L., May, S. G., Rendle, K. A., Tietbohl, C., & Elwyn, G. (2012). Authoritarian physicians and patients’ fear of being labeled ‘difficult’ among key obstacles to shared decision making. Health Affairs, 31(5), 1030–1038. doi:10.1377/hlthaff. 2011.0576.PubMedCrossRef Frosch, D. L., May, S. G., Rendle, K. A., Tietbohl, C., & Elwyn, G. (2012). Authoritarian physicians and patients’ fear of being labeled ‘difficult’ among key obstacles to shared decision making. Health Affairs, 31(5), 1030–1038. doi:10.​1377/​hlthaff. 2011.0576.PubMedCrossRef
Zurück zum Zitat Gensichen, J., Serras, A., Paulitsch, M. A., Rosemann, T., Konig, J., Gerlach, F. M., et al. (2011). The patient assessment of chronic illness care questionnaire: Evaluation in patients with mental disorders in primary care. Community Mental Health Journal, 47(4), 447–453. doi:10.1007/s10597-010-9340-2.PubMedCrossRef Gensichen, J., Serras, A., Paulitsch, M. A., Rosemann, T., Konig, J., Gerlach, F. M., et al. (2011). The patient assessment of chronic illness care questionnaire: Evaluation in patients with mental disorders in primary care. Community Mental Health Journal, 47(4), 447–453. doi:10.​1007/​s10597-010-9340-2.PubMedCrossRef
Zurück zum Zitat Glasgow, R. E., Whitesides, H., Nelson, C. C., & King, D. K. (2005). Use of the patient assessment of chronic illness care (PACIC) with diabetic patients: Relationship to patient characteristics, receipt of care, and self-management. Diabetes Care, 28(11), 2655–2661.PubMedCrossRef Glasgow, R. E., Whitesides, H., Nelson, C. C., & King, D. K. (2005). Use of the patient assessment of chronic illness care (PACIC) with diabetic patients: Relationship to patient characteristics, receipt of care, and self-management. Diabetes Care, 28(11), 2655–2661.PubMedCrossRef
Zurück zum Zitat Goldberg, R. W., Dickerson, F., Lucksted, A., Brown, C. H., Weber, E., Tenhula, W., et al. (2012). Living well: An intervention to improve self-management of medical illness for individuals with serious mental illness. Psychiatric Services,. doi:10.1176/appi.ps.201200034. Goldberg, R. W., Dickerson, F., Lucksted, A., Brown, C. H., Weber, E., Tenhula, W., et al. (2012). Living well: An intervention to improve self-management of medical illness for individuals with serious mental illness. Psychiatric Services,. doi:10.​1176/​appi.​ps.​201200034.
Zurück zum Zitat Hellerstein, D. J., Almeida, G., Devlin, M. J., Mendelsohn, N., Helfand, S., Dragatsi, D., et al. (2007). Assessing obesity and other related health problems of mentally ill Hispanic patients in an urban outpatient setting. Psychiatric Quarterly, 78(3), 171–181.PubMedCrossRef Hellerstein, D. J., Almeida, G., Devlin, M. J., Mendelsohn, N., Helfand, S., Dragatsi, D., et al. (2007). Assessing obesity and other related health problems of mentally ill Hispanic patients in an urban outpatient setting. Psychiatric Quarterly, 78(3), 171–181.PubMedCrossRef
Zurück zum Zitat Henderson, D. C., Nguyen, D. D., Copeland, P. M., Hayden, D. L., Borba, C. P., Louie, P. M., et al. (2005). Clozapine, diabetes mellitus, hyperlipidemia, and cardiovascular risks and mortality: Results of a 10-year naturalistic study. Journal of Clinical Psychiatry, 66(9), 1116–1121.PubMedCrossRef Henderson, D. C., Nguyen, D. D., Copeland, P. M., Hayden, D. L., Borba, C. P., Louie, P. M., et al. (2005). Clozapine, diabetes mellitus, hyperlipidemia, and cardiovascular risks and mortality: Results of a 10-year naturalistic study. Journal of Clinical Psychiatry, 66(9), 1116–1121.PubMedCrossRef
Zurück zum Zitat Hibbard, J. H., & Cunningham, P. J. (2008). How engaged are consumers in their health and health care, and why does it matter? Research Brief, 8, 1–9.PubMed Hibbard, J. H., & Cunningham, P. J. (2008). How engaged are consumers in their health and health care, and why does it matter? Research Brief, 8, 1–9.PubMed
Zurück zum Zitat Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40(6 Pt 1), 1918–1930.PubMedCrossRefPubMedCentral Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40(6 Pt 1), 1918–1930.PubMedCrossRefPubMedCentral
Zurück zum Zitat Hibbard, J. H., & Tusler, M. (2007). Assessing activation stage and employing a “next steps” approach to supporting patient self-management. Journal of Ambulatory Care Management, 30(1), 2–8.PubMedCrossRef Hibbard, J. H., & Tusler, M. (2007). Assessing activation stage and employing a “next steps” approach to supporting patient self-management. Journal of Ambulatory Care Management, 30(1), 2–8.PubMedCrossRef
Zurück zum Zitat Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
Zurück zum Zitat Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academy Press. Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academy Press.
Zurück zum Zitat Institute of Medicine. (2006). Improving quality of health care for mental and substance use conditions: Quality chasm series. Washington, DC: National Academy Press. Institute of Medicine. (2006). Improving quality of health care for mental and substance use conditions: Quality chasm series. Washington, DC: National Academy Press.
Zurück zum Zitat Interian, A., Martinez, I., Rios, L. I., Krejci, J., & Guarnaccia, P. J. (2010). Adaptation of a motivational interviewing intervention to improve antidepressant adherence among Latinos. Cultural Diversity and Ethnic Minority Psychology, 16(2), 215–225. doi:10.1037/a0016072.PubMedCrossRefPubMedCentral Interian, A., Martinez, I., Rios, L. I., Krejci, J., & Guarnaccia, P. J. (2010). Adaptation of a motivational interviewing intervention to improve antidepressant adherence among Latinos. Cultural Diversity and Ethnic Minority Psychology, 16(2), 215–225. doi:10.​1037/​a0016072.PubMedCrossRefPubMedCentral
Zurück zum Zitat Kato, M. M., Currier, M. B., Gomez, C. M., Hall, L., & Gonzalez-Blanco, M. (2004). Prevalence of metabolic syndrome in Hispanic and non-Hispanic patients with schizophrenia. Primary Care Companion: Journal of Clinical Psychiatry, 6(2), 74–77.CrossRef Kato, M. M., Currier, M. B., Gomez, C. M., Hall, L., & Gonzalez-Blanco, M. (2004). Prevalence of metabolic syndrome in Hispanic and non-Hispanic patients with schizophrenia. Primary Care Companion: Journal of Clinical Psychiatry, 6(2), 74–77.CrossRef
Zurück zum Zitat Kilbourne, A. M., Post, E. P., Nossek, A., Drill, L., Cooley, S., & Bauer, M. S. (2008). Improving medical and psychiatric outcomes among individuals with bipolar disorder: A randomized controlled trial. Psychiatric Services, 59(7), 760–768.PubMedCrossRef Kilbourne, A. M., Post, E. P., Nossek, A., Drill, L., Cooley, S., & Bauer, M. S. (2008). Improving medical and psychiatric outcomes among individuals with bipolar disorder: A randomized controlled trial. Psychiatric Services, 59(7), 760–768.PubMedCrossRef
Zurück zum Zitat Lambert, B. L., Chou, C. H., Chang, K. Y., Tafesse, E., & Carson, W. (2005). Antipsychotic exposure and type 2 diabetes among patients with schizophrenia: A matched case-control study of California Medicaid claims. Pharmacoepidemiology Drug Safety, 14(6), 417–425. doi:10.1002/pds.1092.PubMedCrossRef Lambert, B. L., Chou, C. H., Chang, K. Y., Tafesse, E., & Carson, W. (2005). Antipsychotic exposure and type 2 diabetes among patients with schizophrenia: A matched case-control study of California Medicaid claims. Pharmacoepidemiology Drug Safety, 14(6), 417–425. doi:10.​1002/​pds.​1092.PubMedCrossRef
Zurück zum Zitat Lewis-Fernandez, R., & Diaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73(4), 271–295.PubMedCrossRef Lewis-Fernandez, R., & Diaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73(4), 271–295.PubMedCrossRef
Zurück zum Zitat Lillie-Blanton, M., Brodie, M., Rowland, D., Altman, D., & McIntosh, M. (2000). Race, ethnicity, and the health care system: Public perceptions and experiences. Medical Care Research Review, 57(Suppl 1), 218–235.PubMedCrossRef Lillie-Blanton, M., Brodie, M., Rowland, D., Altman, D., & McIntosh, M. (2000). Race, ethnicity, and the health care system: Public perceptions and experiences. Medical Care Research Review, 57(Suppl 1), 218–235.PubMedCrossRef
Zurück zum Zitat Lorig, K., Stewart, A., Ritter, P., González, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications. Lorig, K., Stewart, A., Ritter, P., González, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications.
Zurück zum Zitat McEvoy, J. P., Meyer, J. M., Goff, D. C., Nasrallah, H. A., Davis, S. M., Sullivan, L., et al. (2005). Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the clinical antipsychotic trials of intervention effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophrenia Research, 80(1), 19–32.PubMedCrossRef McEvoy, J. P., Meyer, J. M., Goff, D. C., Nasrallah, H. A., Davis, S. M., Sullivan, L., et al. (2005). Prevalence of the metabolic syndrome in patients with schizophrenia: Baseline results from the clinical antipsychotic trials of intervention effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophrenia Research, 80(1), 19–32.PubMedCrossRef
Zurück zum Zitat Muhr, T. (2004). User’s manual for ATLAS.ti 5.0 (2nd ed.). Berlin: Scientific Software Development. Muhr, T. (2004). User’s manual for ATLAS.ti 5.0 (2nd ed.). Berlin: Scientific Software Development.
Zurück zum Zitat Nasrallah, H. A., Meyer, J. M., Goff, D. C., McEvoy, J. P., Davis, S. M., Stroup, T. S., et al. (2006). Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: Data from the CATIE schizophrenia trial sample at baseline. Schizophrenia Research, 86(1–3), 15–22.PubMedCrossRef Nasrallah, H. A., Meyer, J. M., Goff, D. C., McEvoy, J. P., Davis, S. M., Stroup, T. S., et al. (2006). Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: Data from the CATIE schizophrenia trial sample at baseline. Schizophrenia Research, 86(1–3), 15–22.PubMedCrossRef
Zurück zum Zitat Organista, K. C. (2007). Solving Latino psychosocial and health problems: Theory, practice, and population. Hoboken, NJ: Wiley. Organista, K. C. (2007). Solving Latino psychosocial and health problems: Theory, practice, and population. Hoboken, NJ: Wiley.
Zurück zum Zitat Padgett, D. K. (1998). Qualitative methods in social work research: Challenges and rewards. Thousand Oaks, CA: Sage. Padgett, D. K. (1998). Qualitative methods in social work research: Challenges and rewards. Thousand Oaks, CA: Sage.
Zurück zum Zitat Palmer, R. M., & Meldon, S. W. (2003). Acute Care. In W. R. Hazzard (Ed.), Principles of geriatric medicine and gerontology (pp. 157–168). Boston, MA: McGraw-Hill. Palmer, R. M., & Meldon, S. W. (2003). Acute Care. In W. R. Hazzard (Ed.), Principles of geriatric medicine and gerontology (pp. 157–168). Boston, MA: McGraw-Hill.
Zurück zum Zitat Skolasky, R. L., Mackenzie, E. J., Wegener, S. T., & Riley, L. H, 3rd. (2008). Patient activation and adherence to physical therapy in persons undergoing spine surgery. Spine, 33(21), E784–791.PubMedCrossRef Skolasky, R. L., Mackenzie, E. J., Wegener, S. T., & Riley, L. H, 3rd. (2008). Patient activation and adherence to physical therapy in persons undergoing spine surgery. Spine, 33(21), E784–791.PubMedCrossRef
Zurück zum Zitat Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage. Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.
Zurück zum Zitat Thornicroft, G. (2006). Shunned: Discrimination against people with mental illness. New York: Oxford University Press. Thornicroft, G. (2006). Shunned: Discrimination against people with mental illness. New York: Oxford University Press.
Zurück zum Zitat Zayas, L. H., Cabassa, L. J., & Pérez, M. C. (2005). Capacity-to-consent in psychiatric research: Development and preliminary testing of a screening tool. Research on Social Work Practice, 15(16), 545–556.CrossRef Zayas, L. H., Cabassa, L. J., & Pérez, M. C. (2005). Capacity-to-consent in psychiatric research: Development and preliminary testing of a screening tool. Research on Social Work Practice, 15(16), 545–556.CrossRef
Metadaten
Titel
Primary Health Care Experiences of Hispanics with Serious Mental Illness: A Mixed-Methods Study
verfasst von
Leopoldo J. Cabassa
Arminda P. Gomes
Quisqueya Meyreles
Lucia Capitelli
Richard Younge
Dianna Dragatsi
Juana Alvarez
Andel Nicasio
Benjamin Druss
Roberto Lewis-Fernández
Publikationsdatum
01.11.2014
Verlag
Springer US
Erschienen in
Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 6/2014
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-013-0524-2

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