MGH Center for Child and Adolescent Health Policy, and Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Acad Pediatr. 2010 May-Jun;10(3):172-8. doi: 10.1016/j.acap.2010.01.002. Epub 2010 Mar 27.
To assess the associations of parent-primary care provider language concordance and providers' self-rated cultural competency items with Latino parent report of well-child care quality.
A cross-sectional survey of parents with children 10-50 months old and their children's providers in 3 community health centers. We used the mean scores of quality domains of the Promoting Healthy Development Survey to examine associations of parent-provider language concordance and providers' self-rated cultural competency items with the quality of well-child care provided (all scales range 0-100).
Results are based on 462 Latino parent responses and 22 provider responses. Latino parents in language concordant patient-provider relationships did not report higher-quality well-child care. Higher parent-reported quality of care was associated with provider self-reported effectiveness in treating Latino patients in the domains of family-centered care (mean 80.5 vs 70.6; P = .02) and helpfulness of care (mean 84.2 vs 67.9; P = .02). A language-cultural competency summary scale was associated with the domain assessing family risk factors (+11.2 points; P = .02) and its subdomain of emotional assessment (+16.1 points; P = .02).
Language concordance was not associated with parental reports of quality of well-child care. Provider self-perceived cultural competency was associated with higher scores in domains related to how content is delivered-that is, helpful and family-centered. The language-cultural competency summary score was associated with discussion of sensitive topics. These findings indicate that provider characteristics other than language concordance have greater association with quality of care and may offer opportunities to strengthen cultural competency, even among monolingual providers.
评估父母与初级保健提供者语言一致和提供者自我评估的文化能力项目与拉丁裔父母对儿童保健质量的报告之间的关联。
在 3 家社区卫生中心对 10-50 个月大的儿童及其儿童提供者的父母进行横断面调查。我们使用促进健康发展调查的质量领域的平均分数来检查父母-提供者语言一致性和提供者自我评估的文化能力项目与提供的儿童保健质量之间的关联(所有量表的范围为 0-100)。
结果基于 462 名拉丁裔父母的回答和 22 名提供者的回答。在语言一致的医患关系中,拉丁裔父母没有报告更高质量的儿童保健。父母报告的更高质量的护理与提供者自我报告在以家庭为中心的护理(平均 80.5 对 70.6;P =.02)和护理的有益性(平均 84.2 对 67.9;P =.02)方面有效治疗拉丁裔患者的能力相关。语言文化能力综合量表与评估家庭危险因素的领域(增加 11.2 分;P =.02)及其情绪评估的亚领域(增加 16.1 分;P =.02)相关。
语言一致性与父母对儿童保健质量的报告无关。提供者自我感知的文化能力与与内容传递相关的领域(即有益和以家庭为中心)的更高分数相关。语言文化能力综合评分与敏感话题的讨论有关。这些发现表明,除语言一致性之外,提供者的特征与护理质量的关联更大,即使在单一语言提供者中,也可能提供加强文化能力的机会。