Predmore Zachary, Qureshi Nabeel, Slaughter Mary E, Walsh Shannon, Diaz Yareliz, Talamantes Efrain, Curiel Yesenia, Garcia Rosa Elena, Quigley Denise D
RAND, Boston, United States.
RAND, Santa Monica, United States.
J Immigr Minor Health. 2025 Sep 3. doi: 10.1007/s10903-025-01768-w.
Healthcare provided by bilingual providers or with assistance from qualified interpreters is intended to improve patient-provider communication. Despite federal laws requiring healthcare facilities to provide access to appropriate interpretation language assistance services for patients not proficient in English, many Spanish-preferring patients receive primary care from providers not fluent in Spanish or who regularly use formal interpreters. Partnering with two urban SafetyNet providers in Southern California, we conducted focus groups in Spanish with Spanish-preferring patients who received care from providers who: (1) were Spanish-qualified, (2) used formal interpreters, and (3) used informal interpreters or other communication strategies. We coded transcripts to identify themes and compared patient experiences across provider types. Our study included 62 adult Spanish-preferring primary care patients. Spanish-preferring patients reported preference for continuity with their English-speaking providers despite language barriers because of established rapport. Patients receiving care from Spanish-language-qualified providers reported greater trust, more comprehensive care (i.e., covered more issues with minimal detail), yet with many interactions rushed. Formal interpreters facilitated better understanding and professional communication, however, impersonalized some patient-provider interactions. Informal interpreters or ad-hoc strategies led to mixed experiences, often dependent on patient or provider ability to accurately convey medical information. Overall, Spanish-preferring patient experiences highlighted the necessity for healthcare systems to support robust language and interpretation services that enhance direct communication, ensure interpreter quality, and maintain long-term patient-provider relationships. Improvements in policy and practice are needed to optimize healthcare communication for Spanish-preferring patients, since patient-provider communication is critical for high-quality health outcomes and experiences in multilingual settings.
由双语医疗服务提供者提供或在合格口译员协助下提供的医疗服务旨在改善医患沟通。尽管联邦法律要求医疗机构为英语不熟练的患者提供适当的口译语言辅助服务，但许多更倾向于西班牙语的患者接受的初级护理来自不精通西班牙语或经常使用正式口译员的医疗服务提供者。我们与南加州的两家城市安全网医疗服务提供者合作，对更倾向于西班牙语的患者进行了西班牙语焦点小组访谈，这些患者接受的护理来自以下医疗服务提供者：（1）具备西班牙语能力；（2）使用正式口译员；（3）使用非正式口译员或其他沟通策略。我们对访谈记录进行编码以识别主题，并比较不同类型医疗服务提供者的患者体验。我们的研究纳入了62名更倾向于西班牙语的成年初级护理患者。更倾向于西班牙语的患者表示，尽管存在语言障碍，但由于已建立的融洽关系，他们更愿意与说英语的医疗服务提供者保持连续性。接受具备西班牙语能力的医疗服务提供者护理的患者报告称，他们更信任对方，得到的护理更全面（即涵盖更多问题且细节最少），然而许多互动都很匆忙。正式口译员促进了更好的理解和专业沟通，然而，使一些医患互动变得缺乏人情味。非正式口译员或临时策略带来了好坏参半的体验，这通常取决于患者或医疗服务提供者准确传达医疗信息的能力。总体而言，更倾向于西班牙语的患者体验凸显了医疗系统支持强大的语言和口译服务的必要性，这些服务可增强直接沟通、确保口译质量并维持长期的医患关系。需要改进政策和实践，以优化为更倾向于西班牙语的患者提供的医疗沟通，因为医患沟通对于多语言环境下的高质量健康结果和体验至关重要。
