کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4154846 | 1273728 | 2016 | 5 صفحه PDF | دانلود رایگان |
Introduction26 million Americans have limited English proficiency (LEP). It is well established that language barriers adversely affect health and health care. Despite growing awareness of language barriers, there is essentially a void in the medical literature regarding the influence of language disparity on pediatric surgery patients. This study was designed to assess the impact of patient–provider language concordance on question-asking behavior and patient satisfaction for pediatric surgery patients.MethodsParticipants included families of patients in a General Pediatric Surgery Clinic categorized into 3 groups by patient–provider language concordance: concordant English-speaking, LEP concordant Spanish-speaking, and LEP discordant Spanish-speaking using an interpreter. Clinical visits were audio recorded and the number of patient-initiated questions and the length of clinical encounter were measured. Families were administered a surgery-specific, 5-point Likert scale questionnaire modeled after validated surveys concerning communication, trust, perceived discrimination and patient–provider language concordance. Regression models were performed to analyze associations between language concordance and patient’s question-asking behavior and between language concordance and survey results.ResultsA total of 156 participants were enrolled including 57 concordant-English, 52 LEP concordant-Spanish and 47 LEP-discordant-Spanish. There was significant variation in the mean number of patient-initiated questions among the groups (p = 0.002). Both the English and Spanish concordant groups asked a similar number of questions (p = 0.9), and they both asked more questions compared to the Spanish-discordant participants (p = 0.002 and p = 0.001). Language discordance was associated with fewer questions asked after adjustment for socioeconomic status. Language concordant participants rated higher scores of communication. Both Spanish-concordant and Spanish-discordant patients reported significantly increased preference for, and value of language concordant care. Language discordant participants reported that they desired to ask more questions but were limited by a language barrier (p = 0.001).ConclusionsIn a pediatric surgery clinic, language concordant care increases the number of patient-asked questions during a clinical visit and improves communication suggesting that discordant care is a potential source of disparities in access to information. Future efforts should focus on expanding access to language concordant providers in other surgery subspecialties as a step towards limiting disparities in surgical care for all patients.
Journal: Journal of Pediatric Surgery - Volume 51, Issue 4, April 2016, Pages 670–674