Fields Arielle, Abraham Manjusha, Gaughan John, Haines Christopher, Hoehn K Sarah
From the *Thomas Jefferson University, Philadelphia, PA; †Kansas University School of Medicine, Kansas City, KS; ‡Biostatistics Consulting Center, Temple University School of Medicine, Philadelphia, PA; and §Children's Specialized Hospital, New Brunswick, NJ.
Pediatr Emerg Care. 2016 Apr;32(4):222-6. doi: 10.1097/PEC.0000000000000453.
Trust in physicians and health care system has been positively associated with health care outcomes. The purpose of this study is to explore the relationships among race, ethnicity, language, trust, and health care outcomes.
This prospective cross-sectional study took place in the pediatric emergency department of an intercity hospital. English- and Spanish-speaking guardians were asked to complete a demographic survey, the Pediatric Trust in Physicians Scale, and the Group-Based Medical Mistrust Scale.
Four hundred seventy-five parents were surveyed, of which 21.35% identified as white, 35.05% as African American, and 53.26% as Hispanic; with respect to language: 88% English-speaking and 12% Spanish-speaking. No significant difference was seen in trust scores for sex, ethnicity, or religious affiliation. Non-Hispanics and English speakers demonstrated an overall higher trust in their physician. English-speaking participants were found to have higher percentages in all measured emergency department variables compared to Spanish speakers, including admittance (9.09% and 0.93%, respectively) as well as receiving interventions (42.34% and 5.53%, respectively).
Our study shows that race and ethnicity influence trust and mistrust as well as actual health care outcomes. Interestingly, language barrier proved to be one of the greatest causes of health care disparities. Therefore, more research is needed to find a way to bridge the increasing language barrier between physicians and patients.
对医生和医疗保健系统的信任与医疗保健结果呈正相关。本研究的目的是探讨种族、民族、语言、信任和医疗保健结果之间的关系。
这项前瞻性横断面研究在一家城市医院的儿科急诊科进行。要求讲英语和西班牙语的监护人完成一份人口统计调查问卷、《儿科对医生的信任量表》和《基于群体的医疗不信任量表》。
共对475名家长进行了调查,其中21.35%为白人,35.05%为非裔美国人,53.26%为西班牙裔;在语言方面:88%讲英语,12%讲西班牙语。在性别、民族或宗教信仰的信任得分上未发现显著差异。非西班牙裔和讲英语的人对他们的医生总体上表现出更高的信任。与讲西班牙语的人相比,讲英语的参与者在所有测量的急诊科变量中所占百分比更高,包括入院率(分别为9.09%和0.93%)以及接受干预的比例(分别为42.34%和5.53%)。
我们的研究表明,种族和民族会影响信任和不信任以及实际的医疗保健结果。有趣的是,语言障碍被证明是医疗保健差距的最大原因之一。因此,需要更多的研究来找到一种方法来弥合医生和患者之间日益增加的语言障碍。