"How's your mood": Recorded physician mental health conversations with Chinese and Latino patients in routine primary care visits

Evelyn Y Ho¹, Leah S Karliner², Genevieve Leung³, Raneem Harb⁴, Giselle Aguayo Ramirez², Maria E Garcia⁵

Affiliations

¹ Department of Communication Studies, University of San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, University of California, San Francisco, San Francisco, CA, USA. Electronic address: eyho@usfca.edu.
² Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Rhetoric and Language, University of San Francisco, San Francisco, CA, USA.
⁴ Department of Communication Studies, University of San Francisco, San Francisco, CA, USA.
⁵ Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

PMID: 37364381
PMCID: PMC10528172
DOI: 10.1016/j.pec.2023.107850

"How's your mood": Recorded physician mental health conversations with Chinese and Latino patients in routine primary care visits

Evelyn Y Ho et al. Patient Educ Couns. 2023 Sep.

. 2023 Sep:114:107850.

doi: 10.1016/j.pec.2023.107850. Epub 2023 Jun 10.

Authors

Evelyn Y Ho¹, Leah S Karliner², Genevieve Leung³, Raneem Harb⁴, Giselle Aguayo Ramirez², Maria E Garcia⁵

Affiliations

¹ Department of Communication Studies, University of San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, University of California, San Francisco, San Francisco, CA, USA. Electronic address: eyho@usfca.edu.
² Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Rhetoric and Language, University of San Francisco, San Francisco, CA, USA.
⁴ Department of Communication Studies, University of San Francisco, San Francisco, CA, USA.
⁵ Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

PMID: 37364381
PMCID: PMC10528172
DOI: 10.1016/j.pec.2023.107850

Abstract

Objective: Patient-physician communication patterns may influence discussions around depressive symptoms and contribute to engagement in depression care among racial/ethnic minority adults. We examined patient-physician communication about depressive symptoms during routine primary care visits with Chinese and Latino patients with and without language barriers.

Methods: We examined 17 audio-recorded conversations between primary care physicians and Chinese (N = 7) and Latino (N = 10) patients who discussed mental health during their visit and reported depressive symptoms on a post-visit survey. Conversations (in English, Cantonese, Mandarin, Hoisan-wa, Spanish) were transcribed and translated by bilingual/bicultural research assistants and analyzed using inductive and deductive thematic and discourse analysis.

Results: Patients initiated mental health discussion in eleven visits. Physicians demonstrated care in word choice and sometimes avoided openly mentioning depression; this could contribute to miscommunication around symptoms and treatment goals. Interpreters had difficulty finding single words to convey terms used by either patients or physicians.

Conclusion: Patients and doctors appeared willing to discuss mental health; however, variability in terminology presented challenges in mental health discussions in this culturally and linguistically diverse sample.

Practice implications: Further understanding patient preferred terminology about mental health symptoms and interpreter training in these terms could improve patient-physician communication about depressive symptoms and treatment preferences.

Keywords: Depression; Language barriers; Limited English proficiency; Mental health; Physician patient communication.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest None of the authors have any conflicts of interest.

References

1. Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care. 2003. Oct;26(10):2822–8. - PubMed
1. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001. Aug;63(4):619–30. - PubMed
1. DuBard CA, Garrett J, Gizlice Z. Effect of language on heart attack and stroke awareness among U.S.. Hispanics. Am J Prev Med. 2006. Mar;30(3):189–96. - PubMed
1. Sumlin LL, Garcia TJ, Brown SA, Winter MA, García AA, Brown A, et al. Depression and adherence to lifestyle changes in type 2 diabetes: a systematic review. Diabetes Educ. 2014. Dec;40(6):731–44. - PMC - PubMed
1. Garcia ME, Lee A, Neuhaus J, Gonzalez H, To TM, Haan MN. Diabetes Mellitus as a Risk Factor for Development of Depressive Symptoms in a Population-Based Cohort of Older Mexican Americans. J Am Geriatr Soc. 2016. Mar;64(3):619–24. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

"How's your mood": Recorded physician mental health conversations with Chinese and Latino patients in routine primary care visits

Affiliations

"How's your mood": Recorded physician mental health conversations with Chinese and Latino patients in routine primary care visits

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical