Schwei Rebecca J, Del Pozo Sam, Agger-Gupta Niels, Alvarado-Little Wilma, Bagchi Ann, Chen Alice Hm, Diamond Lisa, Gany Francesca, Wong Doreena, Jacobs Elizabeth A
Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
White Memorial Medical Center, Los Angeles, CA, USA.
Int J Nurs Stud. 2016 Feb;54:36-44. doi: 10.1016/j.ijnurstu.2015.03.001. Epub 2015 Mar 9.
Understanding how to mitigate language barriers is becoming increasingly important for health care providers around the world. Language barriers adversely affect patients in their access to health services; comprehension and adherence; quality of care; and patient and provider satisfaction. In 2003, the United States (US) government made a major change in national policy guidance that significantly affected limited English proficient patients' ability to access language services.
The objectives of this paper are to describe the state of the language barriers literature inside and outside the US since 2003 and to compare the research that was conducted before and after a national policy change occurred in the US. We hypothesize that language barrier research would increase inside and outside the US but that the increase in research would be larger inside the US in response to this national policy change.
We reviewed the research literature on language barriers in health care and conducted a cross sectional analysis by tabulating frequencies for geographic location, language group, methodology, research focus and specialty and compared the literature before and after 2003.
Our sample included 136 studies prior to 2003 and 426 studies from 2003 to 2010. In the 2003-2010 time period there was a new interest in studying the providers' perspective instead of or in addition to the patients' perspective. The methods remained similar between periods with greater than 60% of studies being descriptive and 12% being interventions.
There was an increase in research on language barriers inside and outside the US and we believe this was larger due to the change in the national policy. We suggest that researchers worldwide should move away from simply documenting the existence of language barriers and should begin to focus their research on documenting how language concordant care influences patient outcomes, providing evidence for interventions that mitigate language barriers, and evaluating the cost effectiveness of providing language concordant care to patients with language barriers. We think this is possible if funding agencies around the world begin to request proposals for these types of research studies. Together, we can begin document meaningful ways to provide high quality health care to patients with language barriers.
对于世界各地的医疗服务提供者而言，了解如何减轻语言障碍正变得愈发重要。语言障碍对患者获取医疗服务、理解和依从治疗、医疗质量以及患者与提供者满意度均产生不利影响。2003年，美国政府对国家政策指南进行了重大调整，这极大地影响了英语水平有限的患者获得语言服务的能力。
本文的目的是描述2003年以来美国国内外语言障碍文献的状况，并比较美国国家政策变化前后所开展的研究。我们假设，美国国内外关于语言障碍的研究都会增加，但由于这一国家政策变化，美国国内的研究增长幅度会更大。
我们回顾了医疗保健领域语言障碍的研究文献，并通过统计地理位置、语言群体、方法、研究重点和专业的频率进行横断面分析，比较了2003年之前和之后的文献。
我们的样本包括2003年之前的136项研究和2003年至2010年的426项研究。在2003 - 2010年期间，人们对研究提供者的观点产生了新的兴趣，而非仅关注患者的观点，或在关注患者观点的基础上增加对提供者观点的研究。两个时期的研究方法保持相似，超过60%的研究为描述性研究，12%为干预性研究。
美国国内外关于语言障碍的研究均有所增加，我们认为由于国家政策的变化，美国国内的研究增长幅度更大。我们建议，全球的研究人员应不再仅仅记录语言障碍的存在，而应开始将研究重点放在记录语言匹配的护理如何影响患者结局、为减轻语言障碍的干预措施提供证据，以及评估为有语言障碍的患者提供语言匹配护理的成本效益上。我们认为，如果世界各地的资助机构开始要求提供此类研究的提案，这是有可能实现的。我们共同努力，可以开始记录为有语言障碍的患者提供高质量医疗保健的有意义的方法。
