| This study examined the relationships between cultural characteristics, communication variables, and medical outcomes in HIV-positive racial/ethnic minority patients. Participants included 33 patients and 5 providers across two urban, community medical clinics. The patient sample was 61% African American, 24% Latino, and 15% Other/Mixed. The majority (73%) were male. Providers included one White female physician, one White male nurse practitioner, two White female nurse practitioners, and one White male physician assistant. In this descriptive study, patients completed self-report ratings of their desire for engagement in decision-making prior to their scheduled medical consultation. After their consultations, patients rated their provider regarding engagement in decision-making, interpersonal communication, and working alliance. Patients also completed measures of acculturation, fatalism, familism, and mistrust. Providers rated their engagement of patients in decision-making, the patients' interpersonal style, and working alliance immediately after the consultation. Measures of CD4 count and viral load were obtained from patients' medical records. Cultural characteristics were not related to patient desire for engagement in decision-making. Patient perceptions of being highly informed and involved in decision-making were not related to satisfaction or immune functioning. Patient perceptions of provider affiliation and control, and the complementarity between these two, were also not found to have any significant relation to satisfaction or immune functioning. Though working alliance was not found to have a significant relation to any outcome, the relation between patient perception of a stronger working alliance and higher satisfaction was marginally significant. A match between patient and provider on the bond subscale of working alliance was found to correspond to IMI affiliation complementarity. Though the hypotheses were not supported, certain demographic variables were significantly associated with outcomes. For example, use of antiretroviral medications was associated with lower viral load and gender (i.e., being male) was related to lower CD4. The limitations of this study and directions for future research are discussed. |
