Sobel Andrew D, Ramirez Jose M, Walsh Devin F, Defroda Steven F, Cruz Aristides I
Department of Orthopaedics Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
J Pediatr Orthop. 2020 Jul;40(6):310-313. doi: 10.1097/BPO.0000000000001466.
Given the rapidly increasing population of Spanish-speaking patients in the United States, medical providers must have the capability to effectively communicate both with pediatric patients and their caregivers. The purpose of this study was to query the Spanish language proficiency of pediatric orthopaedic surgeons, assess the educational resources available to Spanish-speaking patients and their families, and identify the barriers to care at academic pediatric orthopaedic centers.
The Web sites of medical centers within the United States that have pediatric orthopaedic surgery fellowships recognized by the Pediatric Orthopaedic Society of North America (POSNA) were accessed. Web sites were investigated for a health library as well as the availability of interpreter services. Profiles of attending surgeons within each Pediatric Orthopaedic Department were evaluated for evidence of Spanish proficiency as well as educational qualifications. Centers were contacted by phone to determine if the resources and physicians who could converse in Spanish were different than what was readily available online and if automated instructions in Spanish or a person who could converse in Spanish were available.
Forty-six centers with 44 fellowship programs were identified. The profiles of 12 of 334 (3.6%) surgeons who completed pediatric orthopaedic fellowships indicated Spanish proficiency. Seventeen physicians (5.1%) were identified as proficient in Spanish after phone calls. Thirty-eight pediatric orthopaedic centers (82.6%) noted interpreter service availability online, although services varied from around-the-clock availability of live interpreters to interpreter phones. When contacted by phone, 45 of 46 centers (97.8%) confirmed the availability of any interpreter service for both inpatient and outpatient settings. Sixteen centers (34.8%) had online information on orthopaedic conditions or surgical care translated into Spanish. Twenty centers (43.5%) did not have automated phone messages in Spanish or live operators that spoke Spanish.
There is a scarcity of surgical providers in pediatric orthopaedic centers proficient in Spanish, demonstrating a large discrepancy with the growing Hispanic population. Interpreter services are widely available, although there is variability in the services provided. Considerable barriers exist to Spanish-speaking patients who attempt to access care by phone or online.
鉴于美国说西班牙语的患者人口迅速增加，医疗服务提供者必须有能力与儿科患者及其护理人员进行有效沟通。本研究的目的是了解儿科骨科医生的西班牙语水平，评估为说西班牙语的患者及其家庭提供的教育资源，并确定学术性儿科骨科中心的护理障碍。
访问了美国境内设有北美儿科骨科学会（POSNA）认可的儿科骨科手术奖学金项目的医疗中心网站。调查网站是否设有健康图书馆以及是否提供口译服务。评估每个儿科骨科部门主治医生的简介，以了解其西班牙语水平和教育背景的相关证据。通过电话联系各中心，以确定能说西班牙语的资源和医生是否与网上提供的信息不同，以及是否有西班牙语自动语音提示或能说西班牙语的人员。
确定了46个中心，其中有44个奖学金项目。在完成儿科骨科奖学金项目的334名外科医生中，有12名（3.6%）的简介显示其具备西班牙语能力。通过电话联系后，确定有17名医生（5.1%）精通西班牙语。38个儿科骨科中心（82.6%）表示网上提供口译服务，不过服务形式各异，从随时提供现场口译到提供口译电话。通过电话联系时，46个中心中有45个（97.8%）确认在住院和门诊环境中均可提供某种口译服务。16个中心（34.8%）有关于骨科病症或手术护理的在线信息被翻译成西班牙语。20个中心（43.5%）没有西班牙语自动语音留言或会说西班牙语的接线员。
儿科骨科中心精通西班牙语的外科医疗服务提供者匮乏，这与不断增长的西班牙裔人口数量形成了巨大差距。口译服务广泛提供，但服务内容存在差异。说西班牙语的患者通过电话或网络获取医疗服务存在相当大的障碍。
