在临床环境中提高专业口译的策略:系统审查
Colleen K Gutman1,2, Christina R Rojas3, Lauren Waidner4
1Department of Emergency Medicine, University of Florida College of Medicine, Gainesville.
JAMA network open
|July 17, 2025
概括
临床医生往往缺乏专业的翻译非英语患者,影响健康结果. 本综述确定了增加口译员使用的策略,强调了更好地衡量结果的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 医学沟通 医学沟通
背景情况:
- 有效的沟通对于患者的健康结果至关重要,但临床医生经常在没有专业翻译的情况下照顾英语水平有限的患者.
- 这种护理差距可能会导致非英语人口的不平等和不理想的健康结果.
研究的目的:
- 系统地审查针对有针对性的行为改变策略的证据,旨在增加在医疗环境中使用专业口译员的数量.
- 通过能力,机会,动机-行为 (COM-B) 模型,确定有效的实施策略,并将其映射到行为变化目标上.
主要方法:
- 对英语同行评审文章进行了数据库 (CINAHL,Embase,PubMed,Ovid MEDLINE,Web of Science) 的全面系统审查.
- 包括干预和观察性研究,报告与医疗环境中的专业口译相关的结果. 数据使用COM-B模型进行了合成.
- 评估了偏差风险,并根据PRISMA指南报告了发现.
主要成果:
- 在17952个记录中,有40项研究 (39项干预) 是符合条件的. 大多数研究都使用了前后设计或质量改进方法.
- 虽然大多数干预 (95%) 显示了专业口译措施的增加,但策略和结果评估的异质性阻止了元分析.
- 常见的策略包括临床医生教育 (51%),改善对口译人员的准入 (46%),标准化政策 (31%),和EHR修改 (36%),针对临床医生的能力,机会和动机.
结论:
- 为了增加专业口译员的使用,存在各种各样的实施策略,但结果评估高度异质.
- 尽管在解释措施方面取得了改进,但仍然有必要了解个别策略的具体影响.
- 需要进一步的研究来完善结果测量,并为医疗保健系统中专业口译服务的有效实施提供信息,以改善患者健康结果.
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