Garcia Maria E, Mutha Sunita, Napoles Anna M, Malevanchik Lev, Williams Mia, Karliner Leah S
Department of Medicine, Center for Aging in Diverse Communities, University of California, San Francisco, San Francisco, California, USA.
Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Health Equity. 2023 Feb 16;7(1):100-108. doi: 10.1089/heq.2022.0023. eCollection 2023.
Patients with language barriers suffer significant health disparities, including adverse events and poor health outcomes. While remote language services can help improve language access, these modalities remain persistently underused. The objective of this study was to understand clinician experiences and challenges using dual-handset interpreter telephones and to inform recommendations for future language access interventions.
We conducted four focus groups with nurses (=14) and resident physicians (=20) to understand attitudes toward dual-handset interpreter telephones in the hospital, including general impressions, effects on communication, situations in which they did and did not use them, and impact on clinical care. Three researchers independently coded all transcripts using a constant comparative approach, meeting repeatedly to discuss coding and to reconcile differences to reach consensus.
We identified five salient themes, including increased language access (improved convenience, flexibility, and versatility of phones over in-person or interpreters); effects on interpersonal processes of care (improved ability to communicate directly with patients); effects on clinical processes of care (improvements in critical patient care functions, including pain and medication management); impact on time (needing extra time for interpreted encounters and perceived delays impacting future use); and patients for whom, and circumstances in which, the dual-handset interpreter telephone is inadequate (e.g., complex discussions, hands-on instruction, or multiple speakers are present).
Our findings indicate that clinicians value dual-handset interpretation in bridging communication barriers and highlight recommendations to guide future implementation interventions to increase the uptake of remote language services in hospital settings.
存在语言障碍的患者面临显著的健康差距，包括不良事件和健康状况不佳。虽然远程语言服务有助于改善语言获取情况，但这些方式的使用仍然一直不足。本研究的目的是了解临床医生使用双手持式口译电话的经验和挑战，并为未来的语言获取干预措施提供建议。
我们与护士（=14名）和住院医师（=20名）进行了四个焦点小组讨论，以了解他们对医院中双手持式口译电话的态度，包括总体印象、对沟通的影响、使用和不使用该电话的情况以及对临床护理的影响。三名研究人员使用持续比较法对所有转录本进行独立编码，反复开会讨论编码并协调差异以达成共识。
我们确定了五个突出主题，包括增加语言获取（与面对面或现场口译相比，电话的便利性、灵活性和通用性有所提高）；对人际护理过程的影响（与患者直接沟通的能力提高）；对临床护理过程的影响（关键患者护理功能得到改善，包括疼痛和药物管理）；对时间的影响（口译会诊需要额外时间，且感知到的延迟影响未来使用）；以及双手持式口译电话不适用的患者和情况（例如，复杂讨论、实践指导或有多个发言者在场）。
我们的研究结果表明，临床医生重视双手持式口译在弥合沟通障碍方面的作用，并突出了相关建议，以指导未来的实施干预措施，增加医院环境中远程语言服务的使用。
