Patricia Katz|Jennifer Barton|Laura Trupin|Gabriela Schmajuk|Jinoos Yazdany|Pedro Ruiz|Edward H. Yelin
Poverty, Depression, or Lost in Translation? Ethnic and Language Variation in Patient?Reported Outcomes in Rheumatoid Arthritis
University of California, San Francisco|Portland VA Medical Center|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|California Pacific Medical Center|University of California, San Francisco
despite advances therapies disparities outcomes documented rheumatoid arthritis ra patients ethnicity english language proficiency goals analyses compare differences ra patientreported outcomes selfidentification ethnicity english language proficiency identify factors might explain differences among groupsdata collected structured telephone interviews longitudinal cohort physiciandiagnosed ra n 438 women included n 335 three groups defined based selfreported ethnicity english proficiency whiteenglish n 219 hispanicenglish n 39 hispanicspanish n 77 outcomes examined patientreported physical functioning pain presence moderate severe fatigue multivariate regression analyses compared outcomes among groups adjusting sociodemographic characteristics health disease factors depressionhispanicspanish women worse function pain fatigue either englishproficient group depression associated outcomes p 00001 accounted greater differentials scores ethnicitylanguage proficiency interaction analyses differences women depressed greater hispanicenglish hispanicspanish nondepressed hispanicspanish scores significantly worse nondepressed hispanicenglish ie impact depression less hispanicspanish women depressed nondepressed women group reported worse outcomes adjustment sociodemographic factors depression language remained significantly associated outcomesdisparities patientreported outcomes may driven less ethnicity sociodemographic psychological factors measurement instruments culturally appropriate equivalent may also hamper meaningful analyses disparities