在一个服务欠缺的城市西班牙裔社区中，语言作为有效医疗保健的障碍所产生的影响。

The impact of language as a barrier to effective health care in an underserved urban Hispanic community.

作者信息

David R A, Rhee M

机构信息

Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA.

出版信息

Mt Sinai J Med. 1998 Oct-Nov;65(5-6):393-7.

PMID:9844369

Abstract

BACKGROUND

Language barriers between patient and physician impact upon effective health care. This phenomenon is not well studied in the literature.

METHODS

A survey was created in English and Spanish, and administered at the ambulatory site for medical housestaff and faculty at a teaching hospital. "Cases" were defined as patients who reported using a translator or as having poor English skills. Patients who reported not using a translator and having good English skills served as controls. Both groups were predominantly of Hispanic origin.

RESULTS

Analysis revealed 68 cases and 193 controls. The survey completion rate was 96%. The data were predominantly categorical. Chi-square analysis was utilized. Both groups responded that understanding medication side effects corresponds to compliance (87% cases vs 93% controls, p = 0.18). More cases responded that side effects were not explained (47% vs 16%, p < 0.001). More controls reported satisfaction with medical care (93% vs 84%, p < 0.05). More controls agreed that their doctors understood how they were feeling, with statistical significance in Hispanic subset analysis (87% vs 72%, p < 0.05). Both groups felt they had enough time to communicate with their doctors (89% vs 88%, p = 0.86). More cases than controls reported having had a mammogram within the last 2 years (78% vs 60%, p < 0.05).

CONCLUSIONS

Lack of explanation of side effects to medication appeared to correlate negatively with compliance with medication. The language barrier correlated negatively with patient satisfaction. Cases reported more preventive testing; test ordering may replace dialogue.

摘要

背景

患者与医生之间的语言障碍会影响有效的医疗保健。这一现象在文献中尚未得到充分研究。

方法

设计了一份英文和西班牙文的调查问卷，并在一家教学医院的门诊为实习医生和教职员工进行了调查。“病例组”定义为报告使用过翻译或英语水平较差的患者。报告未使用翻译且英语水平良好的患者作为对照组。两组主要为西班牙裔。

结果

分析显示有68例病例和193例对照。调查完成率为96%。数据主要为分类数据。采用卡方分析。两组均表示对药物副作用的理解与依从性相关（病例组87%，对照组93%，p = 0.18）。更多病例组患者表示副作用未得到解释（47%对16%，p < 0.001）。更多对照组患者对医疗护理表示满意（93%对84%，p < 0.05）。更多对照组患者同意他们的医生了解他们的感受，在西班牙裔亚组分析中具有统计学意义（87%对72%，p < 0.05）。两组均觉得他们有足够的时间与医生交流（89%对88%，p = 0.86）。病例组比对照组报告在过去2年内进行过乳房X光检查的比例更高（78%对60%，p < 0.05）。