Attributions for Interpersonal Healthcare Mistreatment and Continuity of Care

Although continuity of cancer-related care increases the use of early detection cancer screening exams (Doescher, Saver, Fiscella, & Franks, 2004), and thereby improves treatment outcomes (Mandelblatt et al., 2009), Latino (Latina) women in the U.S. currently report lower continuity of care than non-Latino White (Anglo) women (American Cancer Society, 2010; Doescher, Saver, Fiscella, & Franks, 2001). Such disparities may be due, in part, to interpersonal healthcare mistreatment (Smedley, Stith, & Nelson, 2003), as well as mistreatment-related attributions and emotions (Betancourt, Flynn, & Ormseth, 2011; Tucker, 2008). Therefore, according to Weiner's model of attribution and emotion (1986) as well as Betancourt's Integrative model of Culture, Psychological Processes, and Health Behavior (2009), the aim of this research was to examine the impact of mistreatment-related attributions of intentionality and controllability, as well as negative emotions, on continuity of care among Latino and Anglo women. Two hundred and fourteen Latino and Anglo women who perceived at least one instance of interpersonal healthcare mistreatment were recruited from Southern California using multi-stage stratified sampling. Structural equation modeling confirmed the expected relationships between attributions, negative emotions, and continuity of care, with ethnicity moderating these associations. For Anglos, higher attributions of intentionality were associated with higher attributions of controllability, r = .46, p < .001, and were directly related to lower continuity of care, β = -.38, p < .01. For Latinos, higher attributions of controllability were indirectly related to lower continuity of care through mistreatment-related negative emotions, βindirect = -.12, p < .05. These findings have implications for improving continuity of care in Latino American women, as well as educating healthcare professionals on how attributions and emotions related to patient-professional relationships can impact cancer-related health disparities.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Psychology

Year

2012

Author dc:creator

• Northington, Daniel Joel

Contributors dc:contributor

• Betancourt, Hector
• Flynn, Patricia
• Owen, Jason

• Clinical Psychology
• Healthcare disparities; Cancer; Mammography; Health Behavior - ethnology; Hispanic Americans; Attitude to Health - Hispanic Americans; Breast neoplasms - prevention & control;
• Interpersonal Healthcare mistreatment
• Continuity of care

Statement dc:rights

• This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Language dc:language

English

Repository record dc:identifier

https://scholarsrepository.llu.edu/etd/89

OAI identifier oai:identifier

oai:scholarsrepository.llu.edu:etd-1088