Clients’ Perspectives on Patient-Centeredness: a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida

Fernández, Sofía Berlanga; Ward-Peterson, Melissa; Ramírez-Ortiz, Daisy; Flores, Annette; Santander, Taidiana Gonzalez; Dawit, Rahel; Ibarra, Cynthia; Garcia, Ashley R.; Ladner, Robert A.; Brock, Petra; Jean‐Gilles, Michèle; Ibáñez, Gladys; Dévieux, Jessy G.; Beach, Mary Catherine; Trepka, Mary Jo

doi:10.1007/s40615-022-01281-y

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…The participants ranged in age from 21 to 69 and the average age across studies ranged from 42 to 57. 18 , 26 – 36 Not all studies reported on the socioeconomic status of participants, but those that did described a large proportion of participants as having less than a 4-year college degree with many being low income or living below the poverty line. 26 , 27 , 29 , 31 , 32 , 35 …”

Section: Resultsmentioning

confidence: 99%

“…Fernandez et al 30 sought to understand clients’ perspectives on patient-centered care as it was enacted by medical case managers and medical care providers. The women interviewed highlighted that interpersonal practices enacted by their care providers were facilitators to their retention in care.…”

Section: Resultsmentioning

confidence: 99%

“…In addition to efforts at interpersonal communication, the actions that women responded to included proactive steps to contact them, help them through paperwork if needed, offer appointment reminders, and guidance on health or life-related concerns. 30 Similarly, Boehme's participants described their ideal providers engaging in practices that could be described as patient-centered care. 28 These providers demonstrated care by taking time with their patients, focusing on the things that concerned them, working to stay informed of new developments in treatment, and engaging as if they were friends.…”

Section: Resultsmentioning

confidence: 99%

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The Provider's Role in Retaining Black Women With HIV in Care: A Scoping Review

Hassan,

Coon

2024

J Int Assoc Provid AIDS Care

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Black/African American women represent 54% of new HIV cases among all women in the United States, face higher rates of morbidity and mortality, and are often understudied. The patient–provider relationship is an important motivator to keeping people who live with HIV retained in care and adherent to a medical regimen, thereby improving chances for viral suppression and maintaining overall better health. This scoping review sought to determine the extent of documented provider actions that encourage Black women with HIV to stay engaged in care. The review investigated five databases for peer-reviewed studies in the United States that included Black women from 2009 to 2023 and specifically described beneficial provider actions or behaviors. Of 526 records, 12 met the criteria. Studies revealed that women are motivated by providers who create a respectful, nonjudgmental emotionally supportive relationship with them rather than those who rely on an authoritative transactional exchange of information and orders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Provider's Role in Retaining Black Women With HIV in Care: A Scoping Review

Hassan,

Coon

2024

J Int Assoc Provid AIDS Care

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“… 6 We explore patient perspectives of PCC in another paper. 85 RWP facilities currently evaluate patient survey feedback regarding treatment and interaction with MCMs as part of quality management. 86 Further qualitative work specifically addressing barriers to implementation of PCC is also needed to improve our understanding and guide translation into practice.…”

Section: Discussionmentioning

confidence: 99%

Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida

Knight,

Ward,

Fernandez

et al. 2024

J Int Assoc Provid AIDS Care

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Background: Patient-centered care (PCC) improves HIV adherence and retention, though lack of consensus on its conceptualization and understanding how it is interpreted has hindered implementation. Methods: We recruited 20 HIV providers at Ryan White Programs in FL for in-depth interviews. Thematic analysis identified core consistencies pertaining to: 1) provider perceptions, 2) current practices promoting PCC. Results: Provider perceptions of PCC emerged under four domains: 1) holistic, 2) individualized care, 3) respect for comfort and security, and 4) patient engagement and partnership. PCC practices occurred at multiple levels: 1) individual psychosocial and logistical support, 2) interpersonal support within patient-provider relationships through respectful communication and active engagement, and 3) institutional practices including feedback mechanisms, service integration, patient convenience, and diverse staffing. Conclusions: Our findings highlight the central tenets of PCC as respectful, holistic, individualized, and engaging care. We offer an HIV-adapted framework of PCC as a multilevel construct to guide future intervention.

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“…We conducted an analysis of qualitative data that was collected from a sample of racially and ethnically diverse, low-income women receiving HIV care from the Ryan White Program (RWP) in Miami-Dade County, Florida. Semi-structured, in-depth interviews were conducted September 2019–March 2020 as part of a larger study that aimed to explore women-centered practices that facilitate retention in care and adherence medication among WLH [ 21 ]. Women were eligible to participate if they: (a) were enrolled in the RWP for at least 6 months; (b) were at least 18 years of age; (c) identified as Hispanic/Latina, Haitian, or Black/African American; (d) spoke English, Spanish, or Haitian Creole, and (e) had previously given consent to be contacted for RWP research.…”

Section: Methodsmentioning

confidence: 99%

How patients experience respect in healthcare: findings from a qualitative study among multicultural women living with HIV

Fernandez,

Ahmad,

Beach

et al. 2024

BMC Med Ethics

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Background Respect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians. Methods We analyzed 57 semi-structured interviews conducted at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes. Results Results from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy. Conclusions Findings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery.

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Clients’ Perspectives on Patient-Centeredness: a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida

Cited by 6 publications

References 25 publications

The Provider's Role in Retaining Black Women With HIV in Care: A Scoping Review

The Provider's Role in Retaining Black Women With HIV in Care: A Scoping Review

Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida

How patients experience respect in healthcare: findings from a qualitative study among multicultural women living with HIV

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