Kapoor Ravish, Owusu-Agyemang Pascal, Feng Lei, Cata Juan P
Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
J Pers Med. 2023 Mar 7;13(3):481. doi: 10.3390/jpm13030481.
Language barriers can negatively impact the quality of healthcare. In surgical patients, limited English proficiency (LEP) can lead to disparities in acute postoperative pain management. Interpreters are often used for communication with LEP patients to help alleviate these disparities. We aimed to investigate the impact of the need for language assistance services (LAS) in acute postoperative pain management in patients undergoing oncologic surgery. We retrospectively collected data on adult patients undergoing open abdominal oncologic surgery between March 2016 and August 2021. The need for LAS, patient demographics, treatment and clinical outcomes were obtained from the patient's electronic medical record. The primary endpoint was pain intensity, while secondary endpoints included opioid use in PACU and regional anesthesia. Post-matching analysis (n = 590) demonstrated no significant difference in preoperative variables between patients needing LAS and those not needing LAS. The rate of regional use was slightly lower but not statistically significant in patients needing LAS. Patients needing LAS had significantly lower opioid consumption and reported lower pain intensity in PACU than subjects not requiring translation. In this study, LAS may have aided in the patient decision process regarding the acceptance of regional anesthesia. Although the need for LAS was associated with statistically significant lower pain intensity scores and a corresponding lesser opioid use than no LAS, the margin of differences, especially in pain intensity scores, may not be clinically significant. This may suggest that LAS allowed for better patient-provider communication and appropriate pain management.
语言障碍会对医疗质量产生负面影响。在外科手术患者中,英语水平有限(LEP)会导致急性术后疼痛管理方面的差异。口译员常被用于与英语水平有限的患者进行沟通,以帮助缓解这些差异。我们旨在调查语言辅助服务(LAS)的需求对接受肿瘤手术患者急性术后疼痛管理的影响。我们回顾性收集了2016年3月至2021年8月期间接受开放性腹部肿瘤手术的成年患者的数据。LAS的需求、患者人口统计学信息、治疗及临床结果均从患者的电子病历中获取。主要终点是疼痛强度,次要终点包括麻醉后恢复室(PACU)中的阿片类药物使用情况及区域麻醉。匹配后分析(n = 590)显示,需要LAS的患者与不需要LAS的患者在术前变量方面无显著差异。需要LAS的患者区域麻醉使用率略低,但无统计学意义。与不需要翻译的患者相比,需要LAS的患者在PACU中的阿片类药物消耗量显著更低,且报告的疼痛强度也更低。在本研究中,LAS可能有助于患者在区域麻醉接受方面的决策过程。尽管与不需要LAS相比,需要LAS与疼痛强度评分在统计学上显著更低以及相应的阿片类药物使用量更少相关,但差异幅度,尤其是疼痛强度评分方面的差异,可能在临床上并无显著意义。这可能表明LAS实现了更好的医患沟通及适当的疼痛管理。