Baker D W, Parker R M, Williams M V, Coates W C, Pitkin K
Department of Medicine, Division of General Internal Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
JAMA. 1996 Mar 13;275(10):783-8.
To determine how often interpreters were used for Spanish- speaking patients, patients' perceived need for an interpreter, and the impact of interpreter use on patients' subjective and objective knowledge of their diagnosis and treatment.
Cross-sectional survey.
Public hospital emergency department.
A total of 467 native Spanish-speaking and 63 English-speaking Latino patients presenting with nonurgent medical problems.
Patients' report of whether an interpreter was used, whether one was needed, self-perceived understanding of diagnosis and treatment, and objective knowledge of discharge instructions.
An interpreter was used for 26% of Spanish-speaking patients. For 52%, and interpreter was not used but was not thought to be necessary by the patient. A total of 22% said an interpreter was not used but should have been used. When both the patient's English and the examiner's Spanish were poor, an interpreter was not called 34% of the time, and 87% of the patients who did not have an interpreter thought one should have been used. Nurses and physicians interpreted most frequently (49%), and professional interpreters were used for only 12% of patients. Patients who said an interpreter was not necessary rated their understanding of their disease as good to excellent 67% of the time, compared with 57% of those who used an interpreter and 38% of those who thought an interpreter should have been used (P<.001). For understanding of treatment, the figures were 86%, 82%, and 58%, respectively (P<.001). However, when objective measures of understanding diagnosis and treatment were used, the differences between these groups were smaller and generally not statistically significant. There were no differences between English-speaking Latinos and native Spanish-speakers who said they did not need an interpreter.
Interpreters are often not used despite a perceived need by patients, and the interpreters who are used usually lack formal training in this skill. Language concordance and interpreter use greatly affected patients' perceived understanding of their disease, but a high proportion of patients in all groups had poor knowledge of their diagnosis and recommended treatment.
确定为讲西班牙语的患者使用口译员的频率、患者对口译员的感知需求，以及使用口译员对患者关于其诊断和治疗的主观及客观知识的影响。
横断面调查。
公立医院急诊科。
共有467名以西班牙语为母语的患者和63名讲英语的拉丁裔患者，他们均患有非紧急医疗问题。
患者关于是否使用了口译员、是否需要口译员、对诊断和治疗的自我感知理解以及对出院指导的客观知识的报告。
26%的讲西班牙语的患者使用了口译员。52%的患者未使用口译员，但患者认为没有必要使用。共有22%的患者表示未使用口译员但应该使用。当患者的英语水平和检查人员的西班牙语水平都较差时，34%的情况下未呼叫口译员，87%没有口译员的患者认为应该使用口译员。护士和医生最常进行口译（49%），专业口译员仅用于12%的患者。表示不需要口译员的患者中，67%将他们对疾病的理解评为良好至优秀，相比之下，使用口译员的患者中这一比例为57%，认为应该使用口译员的患者中这一比例为38%（P<0.001）。对于治疗理解，相应数字分别为86%、82%和58%（P<0.001）。然而，当使用对诊断和治疗理解的客观指标时，这些组之间的差异较小且通常无统计学意义。表示不需要口译员的讲英语的拉丁裔患者和以西班牙语为母语的患者之间没有差异。
尽管患者有感知需求，但口译员常常未被使用，而且所使用的口译员通常缺乏该技能的正规培训。语言一致性和口译员的使用极大地影响了患者对其疾病的感知理解，但所有组中都有很大比例的患者对其诊断和推荐治疗的了解较差。
