University of Illinois at Chicago Department of Psychology, Chicago, IL, USA.
Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
J Gen Intern Med. 2024 Nov;39(14):2741-2746. doi: 10.1007/s11606-024-08984-4. Epub 2024 Aug 13.
Despite greater care needs, patients with limited English proficiency (LEP) are less likely to use telemedicine. Given the expansion of telemedicine since the COVID-19 pandemic, identifying ways to narrow the telemedicine care gaps experienced by people with LEP is essential.
Examine the telemedicine experiences of Mandarin-speaking adults with LEP, with a focus on perceived differences between in-person care, video, and telephone telemedicine.
Random sample of Kaiser Permanente Northern California (KPNC) members who completed at least one primary care telemedicine visit in August 2021, aged 40 years or older, and had electronic health record-documented need for a Mandarin interpreter. The sample was stratified by telemedicine visit type (video or phone).
Semi-structured Mandarin-language telephone interviews with a bilingual and bicultural research assistant collected patient experiences with telemedicine in general and telemedicine visits assisted by interpreters. Two coders used rapid qualitative analytic techniques to capture themes.
Among 20 respondents (n = 12, 60% women) age 41-81, all had prior experience with telephone visits and 17 (85%) had experience with video visits. Patients reported three major themes: (1) communication, language skills, and how patience impacts care quality; (2) the importance of matching patient preferences on communication modality; and (3) the need for comprehensive language services throughout the continuum of healthcare delivery.
Mandarin-speaking adults with LEP see telemedicine as a convenient and necessary service. Issues with healthcare providers' and interpreters' communication skills and impatience were common. The lack of wrap-around language-concordant care beyond the visit itself was cited as an ongoing and unaddressed care barrier. Healthcare provider and interpreter training is important, as is availability of personalized and comprehensive language services in promoting patient autonomy, alleviating the burden on patients' families, and thus ensuring equitable healthcare access.
尽管有更多的护理需求，但英语水平有限（LEP）的患者使用远程医疗的可能性较小。鉴于自 COVID-19 大流行以来远程医疗的扩展，确定缩小 LEP 患者体验的远程医疗护理差距的方法至关重要。
检查以普通话为母语的 LEP 成年患者的远程医疗体验，重点关注门诊护理、视频和电话远程医疗之间的感知差异。
随机抽取 2021 年 8 月在 Kaiser Permanente Northern California（KPNC）至少进行过一次初级保健远程医疗就诊、年龄在 40 岁或以上且电子健康记录记录需要普通话口译的 KPNC 会员。该样本按远程医疗就诊类型（视频或电话）分层。
双语和双文化研究助理通过半结构化普通话电话访谈收集患者对远程医疗的一般体验以及口译员协助的远程医疗就诊体验。两名编码员使用快速定性分析技术捕捉主题。
在 20 名受访者（n=12，60%为女性）中，年龄在 41-81 岁之间，所有人都有电话就诊的既往经验，17 人（85%）有视频就诊的经验。患者报告了三个主要主题：（1）沟通、语言技能以及耐心如何影响护理质量；（2）匹配患者对沟通方式偏好的重要性；（3）在整个医疗保健提供过程中需要全面的语言服务。
以普通话为母语的 LEP 成年患者将远程医疗视为一种方便且必要的服务。医疗保健提供者和口译员沟通技巧和缺乏耐心的问题很常见。就诊本身之外缺乏围绕语言一致性的护理服务被认为是一个持续存在且未得到解决的护理障碍。医疗保健提供者和口译员培训很重要，提供个性化和全面的语言服务也很重要，这可以促进患者的自主权，减轻患者家属的负担，从而确保公平获得医疗保健。
