Healthcare discrimination and treatment adherence among sexual and gender minority individuals living with chronic illness: the mediating effects of anticipated discrimination and depressive symptoms.

IF 2.4 3区心理学 Q2 PSYCHOLOGY, MULTIDISCIPLINARY

Psychology & Health Pub Date : 2025-02-01 Epub Date: 2023-06-20 DOI:10.1080/08870446.2023.2220008

Byron D Brooks, Sarah A Job, Andréa R Kaniuka, Rachel Kolb, Paloma Unda Charvel, Fabiana Araújo

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引用次数: 0

Abstract

Background: Sexual and gender minority (SGM) individuals are at increased risk for an array of chronic illness due to minority stress. Up to 70% of SGM individuals report healthcare discrimination, which may cause additional challenges for SGM people living with chronic illness including avoiding necessary healthcare. The extant literature highlights how healthcare discrimination is associated with depressive symptoms and treatment nonadherence. However, there is limited evidence on the underlying mechanisms between healthcare discrimination and treatment adherence among SGM people living with chronic illness.Methods: Among a sample of SGM individuals living with chronic illness (n = 149) recruited from social media, the current study examined the mediating roles of anticipated discrimination and depressive symptoms on the relation between healthcare discrimination and treatment adherence in a serial mediation model.Results: We found that healthcare discrimination was associated with greater anticipated discrimination, increased depressive symptoms, and, in turn, poorer treatment adherence. Conclusion: These findings highlight the association between minority stress and both depressive symptoms and treatment adherence among SGM individuals living with chronic illness. Addressing institutional discrimination and the consequences of minority stress may improve treatment adherence among SGM individuals living with chronic illness.

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慢性疾病患者的医疗歧视和治疗依从性：预期歧视和抑郁症状的中介作用

背景：性和性别少数群体（SGM）个体由于少数群体压力而患一系列慢性疾病的风险增加。高达70%的SGM个体报告了医疗保健歧视，这可能给患有慢性疾病的SGM人群带来额外的挑战，包括避免必要的医疗保健。现有的文献强调如何保健歧视与抑郁症状和治疗不依从。然而，在患有慢性疾病的SGM人群中，关于医疗歧视与治疗依从性之间的潜在机制的证据有限。方法：从社交媒体中招募慢性疾病的SGM个体（n = 149），通过序列中介模型检验预期歧视和抑郁症状在医疗歧视与治疗依从性关系中的中介作用。结果：我们发现医疗保健歧视与更大的预期歧视、抑郁症状增加以及更差的治疗依从性相关。结论：这些发现强调了少数民族压力与慢性疾病的SGM个体的抑郁症状和治疗依从性之间的关联。解决制度歧视和少数民族压力的后果可能会提高患有慢性疾病的SGM个体的治疗依从性。

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来源期刊

Psychology & Health Multiple-

CiteScore

7.30

自引率

3.00%

发文量

期刊介绍： Psychology & Health promotes the study and application of psychological approaches to health and illness. The contents include work on psychological aspects of physical illness, treatment processes and recovery; psychosocial factors in the aetiology of physical illnesses; health attitudes and behaviour, including prevention; the individual-health care system interface particularly communication and psychologically-based interventions. The journal publishes original research, and accepts not only papers describing rigorous empirical work, including meta-analyses, but also those outlining new psychological approaches and interventions in health-related fields.