Effect of race and sex on primary care physicians' diagnosis and treatment of late-life depression.
OBJECTIVES: To examine primary care physician (PCP) contributions toward racial and sex differences in the diagnosis and treatment of late-life depression. DESIGN: Survey using a computerized instrument incorporating video interviews and text, with volunteer PCPs randomly assigned to one of four sta...
| Publicado en: | Journal of the American Geriatrics Society Vol. 53; no. 5; pp. 777 - 785 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2005
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106496032&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106496032 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: May2005 vid: 53 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106496032 106496032 2005117668 10.1111/j.1532-5415.2005.53255.x NLM15877552 106496032 ppf: 777 ppct: 8 formats: tig: atl: Effect of race and sex on primary care physicians' diagnosis and treatment of late-life depression. aug: au: Kales HC Neighbors HW Valenstein M Blow FC McCarthy JF Ignacio RV Taylor KK Gillon L Mellow AM affil: Psychiatry Service (116 A), VAMC, 2215 Fuller Road, Ann Arbor, MI, 48105; kales@umich.edu sug: subj: Cultural Bias Evaluation Decision Making, Clinical Evaluation Depression Diagnosis Depression Drug Therapy Gender Bias Evaluation Patient Simulation Utilization Physician Attitudes Evaluation Physicians, Family Primary Health Care Evaluation Race Factors Sex Factors Aged Aged, 80 and Over Antidepressive Agents Therapeutic Use California Chi Square Test Comparative Studies Descriptive Statistics Female Funding Source Interviews Logistic Regression Male Neuropsychological Tests One-Way Analysis of Variance Pearson's Correlation Coefficient Post Hoc Analysis Racism Evaluation Random Assignment Sexism Evaluation Spearman's Rank Correlation Coefficient Surveys Videorecording Human Aged: 65+ years Aged, 80 & over Female Male ab: OBJECTIVES: To examine primary care physician (PCP) contributions toward racial and sex differences in the diagnosis and treatment of late-life depression. DESIGN: Survey using a computerized instrument incorporating video interviews and text, with volunteer PCPs randomly assigned to one of four standardized video vignettes of an elderly patient depicting late-life depression. Vignettes differed only in the patient/actor's race (white/African-American) or sex. SETTING: American Academy of Family Physicians meeting, San Diego, California, 2002. PARTICIPANTS: One hundred seventy-eight U.S.-practicing postresidency PCPs who were asked to participate in a clinical decision-making study. MEASUREMENTS: The computerized survey instrument assessed PCPs' diagnoses, first-line treatment and management recommendations, and judgment of personal characteristics/behaviors for the patients in the vignettes. RESULTS: Eighty-five percent of all PCPs correctly diagnosed the elderly patient(s) with major depression. There were no significant differences in the diagnosis of depression, treatment recommendations, or PCP assessment of most patient characteristics by the race or sex of the patient/actor in the vignette, but PCP characteristics, most notably the location of medical school training (U.S. vs international), affected the likelihood of a depression diagnosis and treatment recommendations. CONCLUSION: Given standardized symptom-pictures, PCPs are just as likely to diagnose and treat depression in African-American as in white older people, suggesting that bias based simply on apparent patient race is not a likely explanation for the lower rates of depression diagnosis and treatment in older African Americans. PCPs who have trained at international medical schools may benefit from targeted training initiatives on the diagnosis and treatment of late-life depression. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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