一种帮助急诊科临床医生加强与说葡萄牙语患者沟通的翻译辅助工具的设计与试点。

The design and pilot of a translation aid to help ED clinicians enhance communication with the Portuguese-speaking patient.

作者信息

Han Alice, Laranjo Humberto, Friedman Steven M

机构信息

University of Toronto, Toronto, ON, Canada.

出版信息

Int J Emerg Med. 2009 Apr;2(1):41-6. doi: 10.1007/s12245-008-0081-8. Epub 2009 Feb 24.

DOI:10.1007/s12245-008-0081-8

PMID:19390916

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2672976/

Abstract

BACKGROUND

Language barriers hinder health care delivery in settings with culturally diverse populations. Interventions to accommodate non-English-speaking patients have been shown to shorten length of stay and reduce non-urgent visits.

AIMS

Our aim was to design and do a pilot study on an instrument to facilitate history taking with Portuguese-speaking patients in the emergency department (ED).

METHODS

An instrument was designed to facilitate history taking with Portuguese-speaking patients (PSPs). A pocket-sized document incorporated, bilingual, problem-oriented, closed-ended questions for common ED presentations as well as numbers, measurements of time, and anatomy. A paired audio tutorial on a compact disk (CD) demonstrated correct pronunciation of each phrase. A 3-month pilot was undertaken in a downtown teaching hospital on a convenience sample of PSPs who indicated the need for a translator at triage. A trained Portuguese-speaking observer monitored clinician/patient pairs using the instrument and scored differential patient comprehension in a standardized manner. Qualitative patient and clinician impressions were assessed. A follow-up survey assessed emergency physician (EP) impressions of the instrument.

RESULTS

Eight of nine eligible clinician/patient pairs were enrolled. The average proportions of questions answered appropriately in English and then using the instrument were 16.7% and 85.5%, respectively, with mean improvement of 68.8% (confidence interval: 45.6-92.1). Most (7/8) patients agreed that the instrument had helped in communication. Half (4/8) of the clinicians indicated that the tool had helped them communicate, and most (7/8) indicated that they would use the instrument in the future. Few (2/17) physicians utilized the audio guide. Suggested modifications included incorporation of phonetics.

CONCLUSIONS

The pilot of the instrument was well received by patients and resulted in improved communication.

摘要

背景

在文化多元的人群中，语言障碍会妨碍医疗服务的提供。已证明，针对非英语患者的干预措施可缩短住院时间并减少非紧急就诊情况。

目的

我们的目的是设计并开展一项关于一种工具的试点研究，该工具旨在便于在急诊科与讲葡萄牙语的患者进行病史采集。

方法

设计了一种工具以方便与讲葡萄牙语的患者（PSP）进行病史采集。一个袖珍文件包含了针对急诊科常见病症的双语、以问题为导向的封闭式问题，以及数字、时间测量和解剖学内容。一张光盘上的配对音频教程展示了每个短语的正确发音。在一家市中心的教学医院进行了为期3个月的试点，对象是在分诊时表示需要翻译的PSP的便利样本。一名经过培训的讲葡萄牙语的观察员使用该工具监测临床医生/患者对，并以标准化方式对患者的不同理解程度进行评分。评估了患者和临床医生的定性印象。一项后续调查评估了急诊医生（EP）对该工具的印象。

结果

9对符合条件的临床医生/患者对中有8对参与。先用英语然后使用该工具时，问题得到适当回答的平均比例分别为16.7%和85.5%，平均提高了68.8%（置信区间：45.6 - 92.1）。大多数（7/8）患者认为该工具有助于沟通。一半（4/8）的临床医生表示该工具帮助他们进行了沟通，大多数（7/8）表示他们将来会使用该工具。很少（2/17）医生使用音频指南。建议的改进包括加入语音学内容。