Karliner Leah S, Pérez-Stable Eliseo J, Gildengorin Ginny
Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, Center for Aging in Diverse Communities, University of California, San Francisco, Calif. 94143-0320, USA.
J Gen Intern Med. 2004 Feb;19(2):175-83. doi: 10.1111/j.1525-1497.2004.30268.x.
Provision of interpreter services for non-English-speaking patients is a federal requirement. We surveyed clinicians to describe their experience using interpreters.
In this cross-sectional study we surveyed clinicians in three academic outpatient settings in San Francisco (N = 194) regarding their most recent patient encounter which involved an interpreter. Questions about the visit included type of interpreter, satisfaction with content of clinical encounter, potential problems, and frequency of need. Previous training in interpreter use, languages spoken, and demographics were also asked. Questionnaires were self-administered in approximately 10 minutes.
Of 194 questionnaires mailed, 158 were completed (81% response rate) and 67% were from resident physicians. Most respondents (78%) were very satisfied or satisfied with the medical care they provided, 85% felt satisfied with their ability to diagnose a disease and treat a disease, but only 45% were satisfied with their ability to empower the patient with knowledge about their disease, treatment, or medication. Even though 71% felt they were able to make a personal connection with their patient, only 33% felt they had learned about another culture as a result of the encounter. Clinicians reported difficulties eliciting exact symptoms (70%), explaining treatments (44%), and eliciting treatment preferences (51%). Clinicians perceived that lack of knowledge of a patient's culture hindered their ability to provide quality medical care and only 18% felt they were unable to establish trust or rapport. Previous training in interpreter use was associated with increased use of professional interpreters (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.5) and increased satisfaction with medical care provided (OR, 2.6; 95% CI, 1.1 to 6.6).
Clinicians reported communication difficulties affecting their ability to understand symptoms and treat disease, as well as their ability to empower patients regarding their healthcare. Training in the use of interpreters may improve communication and clinical care, and thus health outcomes.
为非英语患者提供口译服务是一项联邦要求。我们对临床医生进行了调查,以描述他们使用口译员的经历。
在这项横断面研究中,我们调查了旧金山三个学术门诊机构的临床医生(N = 194),询问他们最近一次涉及口译员的患者诊疗情况。关于此次诊疗的问题包括口译员类型、对临床诊疗内容的满意度、潜在问题以及需求频率。还询问了他们之前在口译员使用方面的培训情况、所讲语言以及人口统计学信息。问卷大约需要10分钟由医生自行填写。
在邮寄的194份问卷中,158份完成(回复率81%),67%来自住院医师。大多数受访者(78%)对他们提供的医疗服务非常满意或满意,85%对自己诊断疾病和治疗疾病的能力感到满意,但只有45%对自己向患者传授有关其疾病、治疗或药物知识的能力感到满意。尽管71%的人觉得他们能够与患者建立个人联系,但只有33%的人觉得通过这次诊疗了解到了另一种文化。临床医生报告在引出确切症状(70%)、解释治疗方法(44%)以及引出治疗偏好(51%)方面存在困难。临床医生认为对患者文化缺乏了解会妨碍他们提供高质量医疗服务的能力,只有18%的人觉得自己无法建立信任或融洽关系。之前在口译员使用方面的培训与更多地使用专业口译员相关(优势比[OR],3.2;95%置信区间[CI],1.4至7.5),并且与对所提供医疗服务的更高满意度相关(OR,2.6;95%CI,1.1至6.6)。
临床医生报告了沟通困难,这影响了他们理解症状和治疗疾病的能力,以及向患者传授医疗保健知识的能力。口译员使用方面的培训可能会改善沟通和临床护理,从而改善健康结局。