Division of General Pediatrics and Adolescent Medicine (JC Gutierrez-Wu, V Ritter, and KB Flower), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research (JC Gutierrez-Wu), University of North Carolina at Chapel Hill, Chapel Hill, NC.
Division of General Pediatrics and Adolescent Medicine (JC Gutierrez-Wu, V Ritter, and KB Flower), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Division of General Pediatrics (V Ritter and LM Sanders), Stanford University School of Medicine, Palo Alto, Calif.
Acad Pediatr. 2024 Aug;24(6):930-939. doi: 10.1016/j.acap.2024.03.004. Epub 2024 Mar 6.
This study aimed to describe caregiver satisfaction with physician communication over the first two years of life and examine differences by preferred language and the relationship to physician continuity.
Longitudinal data were collected at well visits (2 months to 2 years) from participants in a randomized controlled trial to prevent childhood obesity. Satisfaction with communication was assessed using the validated Communication Assessment Tool (CAT) questionnaire. Changes in the odds of optimal scores were estimated in mixed-effects logistic regression models to evaluate the associations between satisfaction over time and language, interpreter use, and physician continuity.
Of 865 caregivers, 35% were Spanish-speaking. Spanish-speaking caregivers without interpreters had lower odds of an optimal satisfaction score compared with English speakers during the first 2 years, beginning at 2 months [OR 0.64 (95% CI: 0.43, 0.95)]. There was no significant difference in satisfaction between English-speaking caregivers and Spanish-speaking caregivers with an interpreter. The odds of optimal satisfaction scores increased over time for both language groups. For both language groups, odds of an optimal satisfaction score decreased each time a new physician was seen for a visit [OR 0.82 (95% CI: 0.69, 0.97)].
Caregiver satisfaction with physician communication improves over the first two years of well-child visits for both English- and Spanish-speakers. A loss of physician continuity over time was also associated with lower satisfaction. Future interventions to ameliorate communication disparities should ensure adequate interpreter use for primarily Spanish-speaking patients and address continuity issues to improve communication satisfaction.
本研究旨在描述儿童生命最初两年中照顾者对医生沟通的满意度,并考察语言偏好和医生连续性的差异及其与满意度的关系。
本研究的数据来自一项预防儿童肥胖的随机对照试验的定期就诊(2 个月至 2 岁)。使用经过验证的沟通评估工具(CAT)问卷评估沟通满意度。采用混合效应逻辑回归模型估计最佳评分的变化概率,以评估满意度随时间的变化以及与语言、口译员使用和医生连续性之间的关联。
在 865 名照顾者中,有 35%是西班牙语使用者。在最初的 2 年中,即 2 个月时,没有口译员的西班牙语使用者与英语使用者相比,对沟通满意度的最佳评分的可能性较小[比值比 0.64(95%置信区间:0.43,0.95)]。使用口译员的英语使用者和西班牙语使用者之间的满意度没有显著差异。对于这两个语言群体,满意度的最佳评分概率随着时间的推移而增加。对于这两个语言群体,每次就诊时新医生的就诊都会降低满意度的最佳评分概率[比值比 0.82(95%置信区间:0.69,0.97)]。
对于英语和西班牙语使用者来说,在儿童定期就诊的最初两年中,他们对医生沟通的满意度会随着时间的推移而提高。随着时间的推移,医生连续性的丧失也与满意度降低有关。未来改善沟通差异的干预措施应确保为主要讲西班牙语的患者提供足够的口译员,并解决连续性问题以提高沟通满意度。