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The Hispanic Clinic for Pediatric Surgery: A model to improve parent-provider communication for Hispanic pediatric surgery patients.
Jaramillo, Joshua; Snyder, Elizabeth; Dunlap, Jonathan L; Wright, Robert; Mendoza, Fernando; Bruzoni, Matias.
Afiliación
  • Jaramillo J; School of Medicine-Stanford University.
  • Snyder E; School of Medicine-Stanford University.
  • Dunlap JL; School of Medicine-Stanford University.
  • Wright R; Department of Psychology, University of California, Riverside.
  • Mendoza F; Department of Pediatrics-Lucile Packard Children's Hospital at Stanford University.
  • Bruzoni M; Division of Pediatric Surgery-Lucile Packard Children's Hospital at Stanford University. Electronic address: mbruzoni@stanford.edu.
J Pediatr Surg ; 51(4): 670-4, 2016 Apr.
Article en En | MEDLINE | ID: mdl-26474548
INTRODUCTION: 26 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. METHODS: Participants 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. RESULTS: A 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). CONCLUSIONS: In 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pediatría / Relaciones Médico-Paciente / Cirugía General / Hispánicos o Latinos / Satisfacción del Paciente / Barreras de Comunicación / Asistencia Sanitaria Culturalmente Competente Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Equity_inequality Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Surg Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pediatría / Relaciones Médico-Paciente / Cirugía General / Hispánicos o Latinos / Satisfacción del Paciente / Barreras de Comunicación / Asistencia Sanitaria Culturalmente Competente Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Equity_inequality Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Surg Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos