The Relationship Between Patient-Centeredness and Cultural Competence Among Primary Care Physicians in the Southern US
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J Gen Intern Med DOI: 10.1007/s11606-020-06298-9 © Society of General Internal Medicine 2020
INTRODUCTION
Both patient-centeredness (PC) and cultural competence (CC) could reduce health care inequities.1, 2 While distinct concepts, they are related,1, 3 though there is no research exploring their correlation among primary care providers. In order to advance health equity training among health care providers, it is important to examine the correlation between the two concepts. It was hypothesized that there would be a significant relationship between PC and CC among primary care physicians (PCPs); there would be a stronger correlation between PC (caring) and CC than for PC (sharing) and CC; and there would be a relationship between demographic variables and PC/CC variables.
METHODS
Following Morehouse School of Medicine Institutional Review Board approval, a convenience sample of 92 PCPs (family medicine, internal medicine) was recruited in late 2012–early 2013 in the Southern US region. An online questionnaire was distributed to PCPs to test the above-mentioned hypotheses. PC was measured using the 18-item self-report PatientPractitioner Orientation Scale (PPOS), consisting of two subscales: (1) sharing (shared decision-making/information sharing) and (2) caring (discussion of psychosocial issues in medical consultations, treating the patient as a whole person).4 CC was assessed using the 25-item self-report Cultural Competence Assessment (CCA), also including two subscales: (1) CC awareness/sensitivity and (2) CC behaviors.5 At the time the research was conducted, Dr. Xanthos was an Assistant Professor at Morehouse School of Medicine. Prior Presentations The preliminary results of this study were presented as a poster at the Morehouse College Health Disparities Symposium, April 17, 2013, Atlanta, GA. Received June 25, 2020 Accepted October 5, 2020
Descriptive statistics were computed for the variables of interest; Pearson’s correlation analysis was used to test the strength of the association between PPOS and CCA scores; and the scores were assessed for a relationship with the demographics (years since medical school graduation, gender, cultural identity, and previous cultural competence training) using a one-way ANOVA (PASW Statistics 18, SPSS).
RESULTS
The sample consisted of 52 (56.5%) women and 40 (43.5%) men; 58 (63.7%) were White, 18 (19.8 %) were Black/African-American, 13 (14.3%) were Asian, and 2 (2.2%) identified with more than one group (Table 1). The average number of years since graduation from medical school was 20.37 and 83.7% of PCPs (77 participants) had participated in CC training (Table 1). The mean PPOS score (patient-centeredness) was 4.88 (highest possible score is 6) and the mean CCA score (cultural competence) was 3.75 (highest possible score is 5). There was a moderate correlation between PC and CC scores among the PCPs (r = 0.403, p < 0.0005). The “caring” element of PC was more closely associated with CC (r = 0.417, p < 0.0005) than the “sharing” component of PC (r = 0.277, p = 0.
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