Patient-Physician Language Concordance and Lifestyle Counseling Among Spanish-Speaking Patients
Patient-Physician Language Concordance and Lifestyle Counseling Among Spanish-Speaking Patients
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DOI：
10.1007/s10903-008-9222-7
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发表时间：
2009-12-01
影响因子：
1.9
通讯作者：
Wee, Christina C.
中科院分区：
文献类型：
--
作者：
Eamranond, Pracha P.;Davis, Roger B.;Wee, Christina C.
目的：对于英语水平有限的患者，患者与医生之间的语言不一致与较差的医疗质量相关。语言不一致的医生的患者有更多的问题理解医疗情况。患者-医生语言一致性对西班牙语患者生活方式咨询的影响尚不清楚。方法：我们进行了回顾性的病历审查，并确定了306西班牙语患者谁使用翻译服务2001年6月至2006年6月在两个波士顿的初级保健实践。我们的主要结果是关于运动、饮食和吸烟的咨询。我们的主要预测兴趣是病人-医生的语言一致性。结果：与语言不一致的医生相比，语言一致的医生更有可能对患者进行饮食和体力活动方面的咨询。在对年龄、性别、保险状况、初级保健就诊次数和合并症评分进行调整后，饮食[比值比（OR）= 2.2，CI 1.3-3.7]和体力活动（OR = 2.3，CI 1.4-3.8）方面的咨询差异持续存在。关于吸烟的讨论没有显著差异（OR = 1.3，CI 0.8-2.1）。结论：与那些有非西班牙语医生的患者相比，讲西班牙语的患者更有可能在有讲西班牙语的医生的情况下讨论饮食和运动的改变。还需要进一步的研究来探讨是否匹配讲西班牙语的患者与讲西班牙语的提供者可以改善生活方式咨询。
Objective Patient-physician language discordance is associated with worse quality of healthcare for patients with limited English proficiency. Patients with language-discordant physicians have more problems understanding medical situations. The impact of patient-physician language concordance on lifestyle counseling among Spanish-speaking patients is not known. Methods We performed a retrospective medical record review and identified 306 Spanish-speaking patients who used interpreter services between June 2001 and June 2006 in two Boston-based primary care practices. Our primary outcome was counseling on exercise, diet, and smoking. Our main predictor of interest was patient-physician language concordance. Results Patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients with language-discordant physicians. After adjustment for age, sex, insurance status, number of primary care visits, and comorbidity score, these differences in counseling persisted for diet [odds ratio (OR) = 2.2, CI 1.3-3.7] and physical activity (OR = 2.3, CI 1.4-3.8). There was no significant difference with regard to discussion of smoking (OR = 1.3, CI 0.8-2.1). Conclusions Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician compared to those having a non-Spanish-speaking physician. Further research is needed to explore whether matching Spanish-speaking patients with Spanish-speaking providers may improve lifestyle counseling.