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

Evelyn Y Ho; Leah S Karliner; Genevieve Leung; Raneem Harb; Giselle Aguayo Ramirez; Maria E Garcia

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

Patient Educ Couns. 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.

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Communication Barriers
Communication*
East Asian People
Ethnicity
Hispanic or Latino / psychology
Humans
Mental Health*
Minority Groups
Physician-Patient Relations*
Physicians
Primary Health Care

Abstract

Publication types

MeSH terms

Grants and funding