Completeness of Written Discharge Guidance for English- and Spanish-Speaking Patient Families.
Completeness of Written Discharge Guidance for English- and Spanish-Speaking Patient Families.
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DOI：
10.1542/hpeds.2018-0250
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发表时间：
2019-07-01
影响因子：
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通讯作者：
Rosenthal, Jennifer L
中科院分区：
文献类型：
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作者：
Platter, Erin;Hamline, Michelle Y;Rosenthal, Jennifer L
目标：住院儿科患者的书面出院指导应包括语言适当的关键要素，以确保积极的出院结果。我们本研究的目的是确定书面儿科出院指南的完整性，并检验以下假设：英语水平有限 (LEP) 的西班牙语家庭收到的书面出院指南不如英语家庭完整。 方法：我们对城市非独立儿童医院向 100 个英语家庭和 100 个西班牙语家庭提供的书面出院指南进行回顾性审查，以评估关键要素的包含情况：后续计划、应急计划、电话接触、出院药物、出院诊断和住院过程。我们比较了英语家庭和西班牙语家庭出院指南的完整性（适用要素数量中提供的要素数量）。 结果：在评估出院指南是否存在任何语言的关键要素时，英语家庭和西班牙语家庭之间没有显着差异。然而，英语和西班牙语家庭的语言适当出院指导的平均完整性分别为 87.8%（95% 置信区间 [CI] 84.4%-91.1%）和 16.0%（95% CI 11.5%-20.4%）。序数逻辑回归检查了关键要素缺陷数量与英语（参考组）与西班牙语家庭之间的关联，结果显示调整后的比值比为 339.8 (95% CI 112.4-1027.5)。结论：很少有 LEP 西班牙语家庭会收到以其首选语言提供的书面出院指导。完整的、语言适当的出院指导被确定为改进工作的一个领域，以努力改善为 LEP 家庭提供的护理。
OBJECTIVES: Written discharge guidance for hospitalized pediatric patients should include language-appropriate key elements to ensure positive discharge outcomes. Our objective in this study was to determine the completeness of written pediatric discharge guidance and to test the hypothesis that Spanish-speaking families with limited English proficiency (LEP) receive less complete written discharge guidance than English-speaking families.METHODS: We conducted a retrospective review of written discharge guidance provided to 100 English- and 100 Spanish-speaking families at an urban nonfreestanding children's hospital to assess the inclusion of key elements: follow-up plan, contingency plan, telephone contact, discharge medications, discharge diagnosis, and hospital course. We compared the completeness of discharge guidance (number of elements provided among number of applicable elements) between English- versus Spanish-speaking families.RESULTS: When evaluating discharge guidance for the presence of key elements in any language, there was no significant difference between English- and Spanish-speaking families. However, the mean completeness of language-appropriate discharge guidance for English- and Spanish-speaking families was 87.8% (95% confidence interval [CI] 84.4%-91.1%) and 16.0% (95% CI 11.5%-20.4%), respectively. The ordinal logistic regression examining the association between the number of key element deficits and English- (reference group) versus Spanish-speaking families demonstrated an adjusted odds ratio of 339.8 (95% CI 112.4-1027.5).CONCLUSIONS: Few Spanish-speaking families with LEP receive written discharge guidance in their preferred language. Complete, language-appropriate discharge guidance was identified as an area for improvement efforts to work toward improving care provided to families with LEP.