Folsom S M, Olawaiye A B, Taylor S E
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Gynecol Oncol Rep. 2024 Dec 14;57:101655. doi: 10.1016/j.gore.2024.101655. eCollection 2025 Feb.
In diversity, equity and inclusion research, overcoming barriers in language discordant patient care is one of the largest and most challenging gaps. It is well established that patients with limited English proficiency (LEP) have higher rates of misdiagnosis, medical errors, and serious adverse events, and recommended best practices for LEP patient care are often not followed.
Our team sought to elicit provider perspectives regarding the barriers they face in caring for LEP patients-especially the unique challenges faced when caring for patients with complex and sensitive diagnoses such as gynecologic cancer.
A national survey was conducted through the Society of Gynecologic Oncology survey database during November and December of 2023. The survey included questions regarding the landscape of LEP patient care in varied geographic settings and practice types. It queried providers regarding available support and resources, as well as tools practitioners would recommend to improve care for LEP patients with gynecologic cancer. The results were assessed using descriptive statistics and Likert Scales and analyzed using t-tests, Fisher's Exact test, Chi-square analysis and ANOVA.
188 respondents completed the survey. Spanish was the most spoken non-English language in providers' patient populations; however, 39 different languages were reported as commonly spoken. Providers reported increases in stress and a lack of time in caring for LEP patients. When asked what interventions providers would recommend to improve LEP patient care, providers asked for more in-person interpreters (40%), more written patient instructions in needed languages (32%), and more time (17%).
Understanding barriers to best practices in LEP patient care is vital to planning future interventions. While this survey was limited by the small percentage of respondents, it provides foundational information for future interventions intended to relieve over-burdened practitioners and systems and achieve the ultimate goal of improved outcomes for LEP patients.
在多元化、公平性和包容性研究中，克服语言不通患者护理方面的障碍是最大且最具挑战性的差距之一。众所周知，英语水平有限（LEP）的患者误诊率、医疗差错率和严重不良事件发生率更高，而针对LEP患者护理的推荐最佳实践往往未得到遵循。
我们的团队旨在了解医疗服务提供者在护理LEP患者时所面临的障碍，尤其是在护理患有复杂和敏感诊断（如妇科癌症）的患者时所面临的独特挑战。
2023年11月和12月通过妇科肿瘤学会调查数据库进行了一项全国性调查。该调查包括有关不同地理环境和执业类型中LEP患者护理情况的问题。它询问了医疗服务提供者有关可用的支持和资源，以及从业者会推荐哪些工具来改善对患有妇科癌症的LEP患者的护理。使用描述性统计和李克特量表对结果进行评估，并使用t检验、费舍尔精确检验、卡方分析和方差分析进行分析。
188名受访者完成了调查。西班牙语是医疗服务提供者患者群体中最常说的非英语语言；然而，据报告共有39种不同语言被普遍使用。医疗服务提供者表示，护理LEP患者时压力增加且时间不足。当被问及会推荐哪些干预措施来改善LEP患者护理时，医疗服务提供者要求增加更多现场口译员（40%）、更多用所需语言编写的患者指导说明（32%）以及更多时间（17%）。
了解LEP患者护理最佳实践的障碍对于规划未来的干预措施至关重要。虽然这项调查受到受访者比例较小的限制，但它为未来旨在减轻负担过重的从业者和系统压力并实现改善LEP患者结局这一最终目标的干预措施提供了基础信息。
