Effect of Telephone vs Video Interpretation on Parent Comprehension, Communication, and Utilization in the Pediatric Emergency Department A Randomized Clinical Trial
Effect of Telephone vs Video Interpretation on Parent Comprehension, Communication, and Utilization in the Pediatric Emergency Department A Randomized Clinical Trial
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DOI：
10.1001/jamapediatrics.2015.2630
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发表时间：
2015-12-01
期刊：
影响因子：
26.1
通讯作者：
Mangione-Smith, Rita
中科院分区：
文献类型：
--
作者：
Lion, K. Casey;Brown, Julie C.;Mangione-Smith, Rita
重要性一致的专业口译可改善与英语水平有限的患者的沟通。远程模式（电话和视频）有可能广泛dissemination. ObjectiveTo测试的影响，电话与视频口译沟通在儿科急诊care.DESIGN，设置，和参与者电话与视频口译在一个独立的，大学附属儿科急诊科（艾德）的随机试验。从2014年2月24日至8月16日，对290名英语水平有限的儿童艾德患者的西班牙语父母进行了方便抽样，其中249人（85.9%）入组;其中208人（83.5%）完成了随访调查（电话组91名父母，视频组117名父母）。各组在知情同意或调查完成率、艾德因素（例如，艾德拥挤）、儿童因素（例如，分诊水平、医疗复杂性）或父母因素（例如，出生国、收入）方面无显著差异。在结果确定期间，研究者对解释模式不知情。意向治疗数据进行了分析，2014年8月25日至10月20日。干预电话或视频解释的艾德访问，随机day.Main结果和措施父母进行了调查后1至7天的艾德访问，以评估沟通和解释质量，频率的失误，在口译员的使用，并能够命名儿童的诊断。两个盲法的评价者比较了父母报告的诊断和医疗记录摘要的诊断，并将父母报告的诊断分为正确、不正确或模糊。结果在208名完成调查的父母中，视频组的父母比电话组的父母更有可能正确说出孩子的诊断（85/114 [74.6%] vs 52/87 [59.8%]; P = 0.03），并且不太可能报告频繁的口译失误（2/117 [1.7%] vs 7/91 [7.7%]; P = 0.04）。视频组和电话组在父母报告的沟通质量（101/116 [87.1%] vs 74/89 [83.1%]; P = 0.43）或解释（58/116 [50.0%] vs 42/89 [47.2%]; P = 0.69）方面没有发现差异。视频判读的成本更高（每例患者的平均[SD]成本，61美元[36美元] vs 31美元[20美元]; P < .001）。家长报告的遵守分配的方式是较高的视频手臂（106 114 [93.0%]对68 86 [79.1%]; P = .004）。结论和相关性有限的英语水平的家庭谁收到视频翻译更有可能正确地命名孩子的诊断和翻译使用失误较少。使用视频解释显示改善沟通和病人护理在这一人群的承诺。
IMPORTANCE Consistent professional interpretation improves communication with patients who have limited English proficiency. Remote modalities (telephone and video) have the potential for wide dissemination.OBJECTIVE To test the effect of telephone vs video interpretation on communication during pediatric emergency care.DESIGN, SETTING, AND PARTICIPANTS Randomized trial of telephone vs video interpretation at a free-standing, university-affiliated pediatric emergency department (ED). A convenience sample of 290 Spanish-speaking parents of pediatric ED patients with limited English proficiency were approached from February 24 through August 16, 2014, of whom 249 (85.9%) enrolled; of these, 208 (83.5%) completed the follow-up survey (91 parents in the telephone arm and 117 in the video arm). Groups did not differ significantly by consent or survey completion rate, ED factors (eg, ED crowding), child factors (eg, triage level, medical complexity), or parent factors (eg, birth country, income). Investigators were blinded to the interpretation modality during outcome ascertainment. Intention-to-treat data were analyzed August 25 to October 20, 2014.INTERVENTIONS Telephone or video interpretation for the ED visit, randomized by day.MAIN OUTCOMES AND MEASURES Parents were surveyed 1 to 7 days after the ED visit to assess communication and interpretation quality, frequency of lapses in interpreter use, and ability to name the child's diagnosis. Two blinded reviewers compared parent-reported and medical record-abstracted diagnoses and classified parent-reported diagnoses as correct, incorrect, or vague.RESULTS Among 208 parents who completed the survey, those in the video arm were more likely to name the child's diagnosis correctly than those in the telephone arm (85 of 114 [74.6%] vs 52 of 87 [59.8%]; P = .03) and less likely to report frequent lapses in interpreter use (2 of 117 [1.7%] vs 7 of 91 [7.7%]; P = .04). No differences were found between the video and telephone arms in parent-reported quality of communication (101 of 116 [87.1%] vs 74 of 89 [83.1%]; P = .43) or interpretation (58 of 116 [50.0%] vs 42 of 89 [47.2%]; P = .69). Video interpretation was more costly (per-patient mean [SD] cost, $61 [$36] vs $31 [$20]; P < .001). Parent-reported adherence to the assigned modality was higher for the video arm (106 of 114 [93.0%] vs 68 of 86 [79.1%]; P = .004).CONCLUSIONS AND RELEVANCE Families with limited English proficiency who received video interpretation were more likely to correctly name the child's diagnosis and had fewer lapses in interpreter use. Use of video interpretation shows promise for improving communication and patient care in this population.