Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, MN, United States of America.
Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, United States of America; University of Minnesota Medical School, Duluth Campus, MN, United States of America.
J Crit Care. 2021 Feb;61:247-251. doi: 10.1016/j.jcrc.2020.10.012. Epub 2020 Oct 17.
To understand the healthcare team's perceptions of the negative consequences of suboptimal communication and their recommendations to improve communication with patients and families who have Limited English Proficiency (LEP) in the Intensive Care Unit (ICU).
We performed a qualitative study using semi-structured interviews of physicians, nurses, and interpreters from 3 ICUs at Mayo Clinic Rochester, between November 2017 and April 2018.
We identified 5 consequences of suboptimal communication: 1) Suboptimal assessment and treatment of patient symptoms, 2) Unmet patient and family expectations, 3) Decreased patient autonomy, 4) Unmet end of life wishes and 5) Clinician Distress. Recommendations to improve communication include: 1) Education and training for patients,families, clinicians and interpreters, 4) Greater integration of interpreters into the ICU team 5) Standardized timeline for goals of care conversations with patients and families with LEP.
Patients with LEP are at risk of experiencing suboptimal communication with the healthcare team in the ICU. There are several educational and quality improvement strategies that ICUs and institutions can take to mitigate these issues.
了解医疗团队对沟通不佳的负面影响的看法，以及他们改善与 ICU 中英语能力有限（LEP）患者和家属沟通的建议。
我们于 2017 年 11 月至 2018 年 4 月在梅奥诊所罗切斯特的 3 个 ICU 进行了一项定性研究，采用半结构式访谈的方式对医生、护士和口译员进行了访谈。
我们确定了沟通不佳的 5 个后果：1）患者症状的评估和治疗不佳，2）患者和家属的期望未得到满足，3）患者自主权降低，4）临终愿望未得到满足，5）临床医生的困扰。改善沟通的建议包括：1）对患者、家属、临床医生和口译员进行教育和培训，4）将口译员更充分地融入 ICU 团队，5）为有 LEP 的患者和家属制定标准化的关怀目标对话时间表。
LEP 患者在 ICU 与医疗团队沟通时存在沟通不佳的风险。ICU 和医疗机构可以采取多种教育和质量改进策略来减轻这些问题。
