Division of General Internal Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Ann Allergy Asthma Immunol. 2012 Sep;109(3):179-84. doi: 10.1016/j.anai.2012.06.016. Epub 2012 Jul 18.
Asthma is a growing cause of morbidity for elderly Americans and is highly prevalent among Hispanic people in the United States. The inability to speak English poses a barrier to patient-provider communication.
To evaluate associations between limited English proficiency, asthma self-management, and outcomes in elderly Hispanic patients.
Elderly patients with asthma receiving primary care at clinics in New York City and Chicago were studied.
Of 268 patients in the study, 68% were non-Hispanic, 18% English-proficient Hispanic, and 14% Hispanic with limited English proficiency. Unadjusted analyses showed that Hispanic persons with limited English proficiency had worse asthma control (P = .0007), increased likelihood of inpatient visits (P = .002), and poorer quality of life (P < .0001). We also found significant associations between limited English proficiency and poorer medication adherence (P = .006). Similar results were obtained in multiple regression analyses adjusting for demographics, asthma history, comorbidities, depression, and health literacy.
Limited English proficiency was associated with poorer self-management and worse outcomes among elderly patients with asthma. Further understanding of mechanisms underlying this relationship is necessary to develop interventions that improve asthma outcomes in this vulnerable population.
哮喘是导致美国老年人发病率上升的一个日益严重的原因，而且在美国西班牙裔人群中也非常普遍。不会说英语给医患沟通带来了障碍。
评估英语能力有限、哮喘自我管理与老年西班牙裔患者结局之间的相关性。
研究对象为在纽约市和芝加哥的诊所接受初级保健的老年哮喘患者。
在 268 名研究患者中，68%为非西班牙裔，18%为英语熟练的西班牙裔，14%为英语能力有限的西班牙裔。未经调整的分析表明，英语能力有限的西班牙裔患者哮喘控制更差（P =.0007），住院就诊的可能性更高（P =.002），生活质量更差（P <.0001）。我们还发现英语能力有限与药物依从性更差之间存在显著关联（P =.006）。在调整人口统计学、哮喘史、合并症、抑郁和健康素养等因素的多元回归分析中也得到了类似的结果。
英语能力有限与老年哮喘患者自我管理更差和结局更差相关。需要进一步了解这种关系的机制，以便为这一脆弱人群开发改善哮喘结局的干预措施。
