Departments of *Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service †Medicine, Memorial Sloan-Kettering Cancer Center ‡Department of Public Health, Weill Cornell Medical College, New York, NY §Palo Alto Medical Foundation Research Institute, Palo Alto, CA ∥Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA ¶Department of Medicine & Health Innovation Program, University of Wisconsin, Madison, WI.
Med Care. 2014 May;52(5):435-8. doi: 10.1097/MLR.0000000000000102.
Individuals with limited English proficiency experience poor patient-clinician communication. Most studies of language concordance have not measured clinician non-English-language proficiency.
To evaluate the accuracy of the self-assessment of non-English-language proficiency by clinicians compared with an oral proficiency interview.
Primary care providers (PCPs) in California and Massachusetts.
PCPs first completed a self-assessment of non-English-language proficiency using a version of the Interagency Language Roundtable (ILR) Scale, followed by the Clinician Cultural and Linguistic Assessment (CCLA), a validated oral proficiency interview. We used nonparametric approaches to analyze CCLA scores at each ILR scale level and the correlation between CCLA and ILR scale scores.
Sixteen PCPs in California and 51 in Massachusetts participated (n=67). Participants spoke Spanish (79%), followed by Cantonese, Mandarin, French, Portuguese, and Vietnamese. The respondents self-assessed as having "excellent" proficiency 9% of the time, "very good" proficiency 24% of the time, "good" proficiency 46% of the time, "fair" proficiency 18% of the time, and "poor" proficiency 3% of the time. The average CCLA score was 76/100. There was a positive correlation between self-reported ILR scale and CCLA score (σ=0.49, P<0.001). The variance in CCLA scores was wider in the middle categories than in the low or high ILR categories (P=0.003).
Self-assessment of non-English-language proficiency using the ILR correlates to tested language proficiency, particularly on the low and high ends of the scale. Participants who self-assess in the middle of the scale may require additional testing. Further research needs to be conducted to identify the characteristics of PCP whose self-assessments are inaccurate and, thus, require proficiency testing.
英语水平有限的个体经历着较差的医患沟通。大多数语言一致性研究并未衡量临床医生的非英语语言能力。
评估临床医生对非英语语言能力的自我评估与口语能力访谈评估之间的准确性。
加利福尼亚州和马萨诸塞州的初级保健提供者(PCP)。
PCP 首先使用 Interagency Language Roundtable(ILR)量表的一个版本完成对非英语语言能力的自我评估,然后进行 Clinician Cultural and Linguistic Assessment(CCLA),这是一种经过验证的口语能力访谈。我们使用非参数方法分析每个 ILR 量表水平的 CCLA 评分以及 CCLA 和 ILR 量表评分之间的相关性。
加利福尼亚州有 16 名 PCP 和马萨诸塞州有 51 名 PCP 参与(n=67)。参与者说西班牙语(79%),其次是粤语、普通话、法语、葡萄牙语和越南语。受访者自我评估的熟练程度为“优秀”的时间为 9%,“非常好”的时间为 24%,“良好”的时间为 46%,“公平”的时间为 18%,“差”的时间为 3%。平均 CCLA 得分为 76/100。自我报告的 ILR 量表与 CCLA 评分之间存在正相关(σ=0.49,P<0.001)。在低和高 ILR 类别中,CCLA 评分的变化范围较窄,而在中间类别中变化范围较宽(P=0.003)。
使用 ILR 进行非英语语言能力的自我评估与经过测试的语言能力相关,特别是在量表的低和高端。自我评估处于量表中间的参与者可能需要进一步测试。需要进一步研究以确定自我评估不准确的 PCP 的特征,因此需要进行熟练程度测试。