Differences Between Current and Desired Physician Hypertension Management Roles Among Chinese American Seniors: a Qualit
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Department of Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA; 2Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA; 3The Lundquist Institute, Torrance, CA, USA; 4Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 5Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 6American Cancer Society (Eastern Division), New York, NY, USA; 7Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; 8 Geriatric Research Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
BACKGROUND: Though patient-physician racial concordance correlates with better perceived shared decisionmaking, Chinese immigrants report low quality of care and have undertreated hypertension regardless of concordance. OBJECTIVE: To inform efforts to change physician behavior and improve quality of hypertension care, we used role theory to explore differences between Chinese American seniors’ descriptions of current and desired physician roles in hypertension management. DESIGN: Qualitative interviews. PARTICIPANTS: Immigrant Chinese Americans with hypertension age ≥ 65 years in Los Angeles County. APPROACH: We recruited 15 participants from a senior wellness center for language-matched interviews and blood pressure (BP) checks. Participants described current and desired physician activities for hypertension management. Bilingual research assistants translated audio recordings. Using thematic analysis, a threemember team independently reviewed and coded transcripts to identify themes regarding physician roles in hypertension management; discrepancies were discussed to achieve consensus. Themes were checked for validity in four subsequent focus groups. RESULTS: We completed interviews in 2014. Interviewees’ mean age was 70.6 years; seven were female and five had a systolic BP over 150 mmHg. All interviewees reported having race- and language-concordant primary care providers, were prescribed at least one BP medication, and had Medicare. Three major themes encompassed current and desired physician roles in hypertension management: technical expert, empathetic health steward, and health educator. Descriptions of current and desired physician roles differed for all themes, Prior Presentations Results from this study were presented in poster format as “Physician lifestyle counseling among Chinese American seniors with hypertension” at the 2016 American Geriatrics Society Annual Scientific Meeting in Long Beach, CA. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11606-020-06012-9) contains supplementary material, which is available to authorized users. Received December 10, 2019 Accepted June 23, 2020
most prominently for empathetic health steward and health educator. Participants desired but did not consistently experience interpersonal engagement or receive hypertension lifestyle counseling
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