Department of Pediatrics and
Center for Child Health, Behavior and Development and.
Pediatrics. 2021 Feb;147(2). doi: 10.1542/peds.2019-3312.
Professional interpretation for patients with limited English proficiency remains underused. Understanding predictors of use is crucial for intervention. We sought to identify factors associated with professional interpreter use during pediatric emergency department (ED) visits.
We video recorded ED visits for a subset of participants ( = 50; 20% of the total sample) in a randomized trial of telephone versus video interpretation for Spanish-speaking limited English proficiency families. Medical communication events were coded for duration, health professional type, interpreter (none, ad hoc, or professional), and content. With communication event as the unit of analysis, associations between professional interpreter use and assigned interpreter modality, health professional type, and communication content were assessed with multivariate random-effects logistic regression, clustered on the patient.
We analyzed 312 communication events from 50 ED visits (28 telephone arm, 22 video arm). Professional interpretation was used for 36% of communications overall, most often for detailed histories (89%) and least often for procedures (11%) and medication administrations (8%). Speaker type, communication content, and duration were all significantly associated with professional interpreter use. Assignment to video interpretation was associated with significantly increased use of professional interpretation for communication with providers (adjusted odds ratio 2.7; 95% confidence interval: 1.1-7.0).
Professional interpreter use was inconsistent over the course of an ED visit, even for patients enrolled in an interpretation study. Assignment to video rather than telephone interpretation led to greater use of professional interpretation among physicians and nurse practitioners but not nurses and other staff.
专业口译员在为英语水平有限的患者提供服务方面的应用仍未得到充分利用。了解使用口译员的预测因素对于干预措施至关重要。我们旨在确定与儿科急诊就诊期间使用专业口译员相关的因素。
我们在一项西班牙语有限英语能力家庭电话与视频口译随机试验的子集中对急诊就诊进行视频记录（n = 50；占总样本的 20%）。对医疗沟通事件进行编码，包括持续时间、医疗保健专业人员类型、口译员（无、临时或专业）和内容。以沟通事件为分析单位，使用多变量随机效应逻辑回归评估专业口译员使用与指定口译员模式、医疗保健专业人员类型和沟通内容之间的关联，按患者聚类。
我们分析了 50 次急诊就诊中的 312 次沟通事件（28 次电话组，22 次视频组）。总体而言，专业口译员的使用占沟通的 36%，最常用于详细病史（89%），最不常用于程序（11%）和药物管理（8%）。说话者类型、沟通内容和持续时间均与专业口译员的使用显著相关。与视频口译的分配与与医生和执业护士沟通时使用专业口译员的可能性显著增加相关（调整后的优势比 2.7；95%置信区间：1.1-7.0）。
即使在参加口译研究的患者中，急诊就诊过程中专业口译员的使用也不一致。与电话相比，分配给视频口译导致医生和执业护士使用专业口译员的比例更高，但护士和其他工作人员则不然。
