Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 633 N St. Clair, Suite 1800, Chicago, IL 60611, USA.
J Community Health. 2013 Aug;38(4):707-15. doi: 10.1007/s10900-013-9668-y.
To explore patient perceptions of patient-provider communication in breast and cervical cancer-related care among low-income English- and Spanish-speaking women, we examined communication barriers and facilitators reported by patients receiving care at safety net clinics. Participants were interviewed in English or Spanish after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Following an inductive approach, interviews were coded and analyzed by the language spoken with providers and patient-provider language concordance status. Of 78 participants, 53 % (n = 41) were English-speakers and 47 % (n = 37) were Spanish-speakers. All English-speakers were language-concordant with providers. Of Spanish-speakers, 27 % (n = 10) were Spanish-concordant; 38 % (n = 14) were Spanish-discordant, requiring an interpreter; and 35 % (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. English-speakers focused on communication barriers, and difficulty understanding jargon arose as a theme. Spanish-speakers emphasized communication facilitators related to Spanish language use. Themes among all Spanish-speaking sub-groups included appreciation for language support resources and preference for Spanish-speaking providers. Mixed-concordant participants accounted for the majority of Spanish-speakers who reported communication barriers. Our data suggest that, although perception of patient-provider communication may depend on the language spoken throughout the care continuum, jargon is lost when health information is communicated in Spanish. Further, the respective consistency of language concordance or interpretation may play a role in patient perception of patient-provider communication.
为了探索低收入英语和西班牙语女性在乳腺癌和宫颈癌相关护理中对医患沟通的看法,我们研究了在医疗服务提供机构接受治疗的患者报告的沟通障碍和促进因素。参与者在接受异常的乳腺癌或宫颈癌筛查测试或癌症诊断后,以英语或西班牙语接受访谈。采用归纳法,根据与提供者交谈的语言和患者-提供者语言一致情况对访谈进行编码和分析。在 78 名参与者中,53%(n=41)为英语使用者,47%(n=37)为西班牙语使用者。所有英语使用者与提供者的语言一致。西班牙语使用者中,27%(n=10)为西班牙语一致;38%(n=14)为西班牙语不一致,需要口译;35%(n=13)为西班牙语混合一致,在整个护理过程中经历了两种类型的沟通。英语使用者关注沟通障碍,理解行话的困难成为一个主题。西班牙语使用者强调与西班牙语使用相关的沟通促进因素。所有西班牙语亚组的主题都包括对语言支持资源的赞赏以及对讲西班牙语的提供者的偏好。混合一致的参与者占报告沟通障碍的西班牙语使用者的大多数。我们的数据表明,尽管对医患沟通的看法可能取决于整个护理过程中使用的语言,但当健康信息以西班牙语传达时,就会丢失行话。此外,语言一致或解释的相对一致性可能会影响患者对医患沟通的看法。