Title

The provider-patient relationship in HIV-positive Hispanic and non-Hispanic White MSM: Effects on HIV-related quality of life and mood

Date of Award

2006

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Psychology

First Committee Member

Gail H. Ironson, Committee Chair

Second Committee Member

Ron E. F. Duran, Committee Member

Abstract

The present study addressed: (1) the relation between the provider-patient relationship (PPR) and patient outcomes within HIV-positive Hispanic and non-Hispanic, White men; and (2) the moderating effects of ethnicity, sexual orientation, and culture on the relation between PPR and outcome scores. Participants (n = 136) completed baseline measures assessing demographics, quality of provider relationship (PQ, provider support (PS), provider trust (PT), sexual orientation identity (SOI), ethnic identity, quality of life (e.g., overall functioning; health worry) and negative mood (i.e., anxiety; depression). Linear regressions were used to explore the direct relationships between the PPR and patient outcomes (i.e., quality of life; negative mood). PT was significantly related to scores of depression, overall functioning, and health worry. PQ was significantly related to overall functioning and health worry. Hierarchical regression was conducted to examine potential moderation. Ethnicity moderated the relation between PT and anxiety scores, such that among Hispanics there was a stronger relation between PT and anxiety than their non-Hispanic, White peers. SOI moderated the relation between PS and anxiety, such that men with high scores on SOI and low scores on PS reported increased anxiety. Similarly, SOI moderated the relation between PT and overall functioning such that men with high SOI and low PT reported lower scores on overall functioning. These relationships were weaker for their less gay-identified counterparts. Analyses were conducted to explore moderation by cultural variables in the relation between PPR and patient outcomes. Hierarchical regressions were conducted with Hispanic men for cultural variables significantly correlated with outcome scores. Results indicated that ethnic identity was significantly correlated with patient outcomes and moderated the relation between PT and scores of anxiety, depression, overall function, and health worry. Hispanic men who reported higher ethnic identity and low PT scored lower on quality of life and higher negative mood as compared to their less ethnically identified counterparts. HIV-positive, Hispanic men are at greater risk of poor outcomes when they experience lower provider trust, as compared to their non-Hispanic, White peers. This study highlights the impact of patients' relationships with their HIV-health care provider and its effects on quality of life and mood.

Keywords

Health Sciences, Mental Health; Psychology, Clinical; Sociology, Ethnic and Racial Studies; Gender Studies; Hispanic American Studies

Link to Full Text

http://access.library.miami.edu/login?url=http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3243141