Rajbhandari Prabi, Glick Alexander F, Brown Miraides F, VanGeest Jonathan
Division of Hospital Medicine, Department of Pediatrics.
Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York.
Hosp Pediatr. 2023 Mar 1;13(3):191-203. doi: 10.1542/hpeds.2022-006906.
Linguistic services, including verbal interpretation and written translation, are critical to providing equitable health care for families with non-English language preference (NELP). Despite evidence of provider disuse and misuse of linguistic services and resultant adverse outcomes, few studies have assessed the practices of pediatric hospitalists related to the use of linguistic services. Our objectives were to evaluate the current practices of communication and linguistic services used by pediatric hospitalists for hospitalized children with NELP and the barriers encountered in their use.
We conducted a multicenter cross-sectional survey of pediatric hospitalist site leaders through the Pediatric Research in Inpatient Setting network, an independent, hospital-based research network. The survey was created through an iterative process and underwent a face validation process with hospitalists and a survey methodology expert.
We received responses from 72 out of 112 hospitalists (64%). Interpreter services were available widely; translation services were available in 49% of institutions. Difficulty accessing the services timely was reported as the most common barrier. Among respondents, 64% "strongly agree" or "somewhat agree" that they visit and give updates more frequently to English-speaking families than to NELP. Hospitalists reported using interpreter services "always" during 65% of admissions, 57% of discharges, and 40% on rounds.
Families with NELP do not receive appropriate linguistic care when hospitalized. Providers update English-speaking families more frequently than non-English speaking families. Future directions include optimizing workflow to reduce the time constraints on hospitalists and increasing the timeliness and quality of interpreters and translators.
语言服务，包括口头翻译和书面翻译，对于为非英语语言偏好（NELP）家庭提供公平的医疗保健至关重要。尽管有证据表明医疗服务提供者对语言服务的使用不当和滥用以及由此产生的不良后果，但很少有研究评估儿科住院医师在语言服务使用方面的做法。我们的目的是评估儿科住院医师为患有NELP的住院儿童使用的沟通和语言服务的当前做法以及在使用过程中遇到的障碍。
我们通过住院环境儿科研究网络（一个独立的、基于医院的研究网络）对儿科住院医师站点负责人进行了多中心横断面调查。该调查通过迭代过程创建，并与住院医师和调查方法专家进行了表面效度验证过程。
我们收到了112名住院医师中72名（64%）的回复。口译服务广泛可用；49%的机构提供笔译服务。据报告，难以及时获得服务是最常见的障碍。在受访者中，64%“强烈同意”或“有些同意”他们探访说英语家庭并向其提供最新情况的频率高于NELP家庭。住院医师报告在65%的入院时、57%的出院时和40%的查房时“总是”使用口译服务。
患有NELP的家庭在住院时未得到适当的语言护理。医疗服务提供者向说英语家庭提供最新情况的频率高于非英语家庭。未来的方向包括优化工作流程以减少住院医师的时间限制，以及提高口译员和笔译员的及时性和质量。
