基于语言的不平等在输血实践与产科出血
Alexa Cohen1, Samantha Goulding2, Carly Pickett2
1Division of Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA. alcohen212@gmail.com.
Maternal and child health journal
|July 8, 2025
概括
患有产后出血 (PPH) 的非英语母语患者接受的输血减少了,尽管血液损失相似. 这表明PPH护理中的潜在不平等与语言障碍有关.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 现有研究强调了产后出血 (PPH) 结果中的种族,种族和社会经济差异.
- 语言障碍对PPH中母亲结果的影响仍未得到充分研究.
- 调查基于语言的不平等是解决母婴护理差异的关键.
研究的目的:
- 检查患有PPH的个体在孕产妇结果中的基于语言的差异.
- 为了比较PPH的英语主要语言 (EPL) 和非英语主要语言 (NEPL) 患者之间的输血率和其他严重结果.
主要方法:
- 在城市学术机构对PPH患者进行回顾性队列研究 (2020年1月至2022年12月).
- 母语分类为英语初级语言 (EPL) 或非英语初级语言 (NEPL).
- 多变量逻辑回归用于分析初级语言与结果之间的关联,并对共变量进行调整.
主要成果:
- 包括1723名PPH患者:76.3%的EPL,23.7%的NEPL.
- 在EPL和NEPL组之间,类似的定量流血 (QBL).
- 在NEPL患者中,包装红细胞 (pRBC) 输血的比率明显较低 (22.9%与28.2%,p=0.039).
- 调整后的分析显示,NEPL患者接受输血的可能性较低 (aOR 0.7,p=0.04).
- 分布式血管内凝血 (DIC),ICU入院和大规模输血 (4+ pRBC单位) 的比率在各组之间相似.
结论:
- 与英语患者相比,患有PPH的非英语主语言患者接受的输血少于英语患者,尽管血液损失相似.
- 语言障碍可能会阻碍获得必要的干预措施,例如对PPH进行输血.
- 需要对健康素养和语言能力进行进一步的研究,以了解和解决这些输血差异.
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