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面向聋人的健康交流中的视频远程手语口译:一项随机对照试验方案

Video Remote Sign Language Interpreting in Health Communication for Deaf People: Protocol for a Randomized Controlled Trial.

作者信息

Rivas Velarde Minerva, Izquierdo Martinez Laura Catalina, Dalal Jyoti, Martinez-R Angela, Cruz Reyes Danna Lesley, Cuculick Jess, Vallejo-Silva Alexie, Irreño-Sotomonte Jonathan, Groce Nora

机构信息

School Of Health Science, University of Applied Sciences and Arts Western, Geneva, Switzerland.

Institute of Ethics History and Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

JMIR Res Protoc. 2024 Dec 2;13:e64590. doi: 10.2196/64590.

Abstract

BACKGROUND

The current standard of interpretation provision is not efficacious or not acceptable to Deaf patients who communicate using sign language. In-person or video relay interpretation (VRI) sign language interpretation is largely unavailable. There are no clear data on the availability of VRI or in-person interpretation. Given the limited number of available sign language interpreters and the cost, VRI may be more available than in-person. Existing evidence tends to focus on assessing personal preferences of Deaf users regarding interpretation and interpreters' preferences. Although respecting preferences is essential, there is a vacuum of knowledge on how the format of access to interpretation impacts the quality of communication between Deaf persons and health personnel.

OBJECTIVE

This study aims to look at the effectiveness of the VRI system in improving communication outcomes between Deaf patients and doctors versus the available standard of care of the usual communication tools, including informal interpretation, lip- or note-reading, and using their mobile phones to contact a formal or informal interpreter, for Deaf patients aged 18 years and older in Bogota, Colombia.

METHODS

This is a randomized controlled trial with a total sample size of 216 participants, divided into 2 groups: an intervention group, which receives a medical appointment using VRI, and a control group, which receives a medical appointment using standard communication. Both the Deaf participants and the health care professionals will be blinded to the allocation, as they will not know whether the appointment will involve VRI or standard communication until they arrive at the office. The primary outcome measure will be an assessment of communication using a Doctor-Patient Communication Scale. This scale was translated into Colombian Sign Language following a rigorous cultural adaptation and translation procedure. Furthermore, the database contains key clinical variables and recommendations provided by the doctor during a general medicine appointment. We will compute associations.

RESULTS

Recruitment opened on August 24, 2023. As of July 2024, 180 participants had been enrolled. The intervention and data collection were finalized in October 2024. The findings of this study are expected to be submitted for publication in early 2025.

CONCLUSIONS

This study will provide rigorous evidence regarding information and communications technology intervention in health care, addressing empirical challenges in using inclusive research designs in public health. In addition, effective VRI models that address the challenges faced by Deaf people will be tested, implemented, and maintained in low- and middle-income countries. A disability-inclusive evaluative tool for quality communication mediated by VRI in health care is also tested. Ultimately, this will lead to evidence-based recommendations for implementing the Convention on the Rights of Persons with Disabilities (CRPD) in mobile health contexts.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05966623; https://clinicaltrials.gov/study/NCT05966623.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64590.

摘要

背景

当前的口译服务标准对使用手语交流的聋人患者而言既无效也不可接受。现场或视频中继口译(VRI)手语口译服务大多无法提供。关于VRI或现场口译服务的可获得性,尚无明确数据。鉴于可用手语口译员数量有限且成本较高,VRI可能比现场口译更容易获得。现有证据往往侧重于评估聋人用户对口译及口译员的个人偏好。虽然尊重偏好至关重要,但对于获取口译服务的形式如何影响聋人与医护人员之间的沟通质量,目前还存在知识空白。

目的

本研究旨在探讨VRI系统在改善哥伦比亚波哥大18岁及以上聋人患者与医生之间沟通效果方面的有效性,与常规沟通工具(包括非正式口译、唇读或笔记阅读以及使用手机联系正式或非正式口译员)的现有标准护理进行对比。

方法

这是一项随机对照试验,总样本量为216名参与者,分为两组:干预组,通过VRI接受医疗预约;对照组,通过标准沟通方式接受医疗预约。聋人参与者和医护人员都将对分组情况不知情,因为在到达办公室之前,他们不知道预约将采用VRI还是标准沟通方式。主要结局指标将是使用医患沟通量表对沟通情况进行评估。该量表经过严格的文化适应和翻译程序后被翻译成哥伦比亚手语。此外,数据库包含医生在普通内科预约期间提供的关键临床变量和建议。我们将计算关联性。

结果

招募工作于2023年8月24日开始。截至2024年7月,已招募180名参与者。干预和数据收集工作于2024年10月完成。本研究结果预计于2025年初提交发表。

结论

本研究将为医疗保健中的信息通信技术干预提供严谨证据,解决公共卫生中使用包容性研究设计时面临的实证挑战。此外,将在低收入和中等收入国家测试、实施和维护有效的VRI模型,以应对聋人面临的挑战。还将测试一种用于评估VRI在医疗保健中介导的高质量沟通的包容性残疾评估工具。最终,这将为在移动健康环境中实施《残疾人权利公约》(CRPD)提供基于证据的建议。

试验注册

ClinicalTrials.gov NCT05966623;https://clinicaltrials.gov/study/NCT05966623。

国际注册报告识别码(IRRID):DERR1-10.2196/64590。

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