临床医师对英语水平有限患者听力损失处理的看法。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-26 DOI:10.1002/ohn.1089
Aparna Govindan, Adina Singer, Lily Zekavat, Tianyi Jia, Kevin Wong, Jianjing Kuang, Maura K Cosetti, Tiffany P Hwa
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引用次数: 0

摘要

目的:在美国,临床医生面临着管理越来越多的英语水平有限(LEP)和听力损失(HL)患者的挑战。本研究旨在探讨提供者对LEP患者HL的评估、咨询和治疗的看法。研究设计:前瞻性描述性研究。环境:三级保健中心。方法:研究人员采用混合方法设计:(1)结构化临床医生访谈,(2)横断面,全国电子调查,都是关于管理LEP患者听力损失的观点。结构化访谈采用修正扎根理论进行分析。结果:29名医护人员参与访谈,其中耳科医生16名,听力学家13名。西班牙语是被报道最多的非英语语言,其次是汉语。四个主题领域:护理障碍,人工耳蜗(CI)候选评估,咨询和理想资源。主要障碍是患者的欲望(97%;N = 28),缺乏有效的试验(72%;n = 21)。CI评估方法包括在验证的语音感知测试中即兴发挥(59%;N = 17)和使用非言语评价(52%;n = 15)。四分之一的非西班牙语患者放弃了语言测试(24%;n = 7)。改善管理的建议包括现场口译(62%;N = 18)和测试所有语言的电池(31%;n = 9)。全国调查结果(n = 87名提供者)表明,受访者对言语感知测试方法和LEP手术听力康复咨询的信心明显不足。结论:临床医生在管理LEP合并HL患者时遇到挑战,包括听力和CI候选性评估的局限性、沟通障碍、信息可及性和文化能力。改善护理的机会包括开发特定语言的测试单元,适合语言和文化的教育材料,以及文化能力培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinician Perspectives on the Management of Hearing Loss in Patients With Limited English Proficiency.

Objective: Clinicians face challenges in managing the growing population of patients with limited English proficiency (LEP) and hearing loss (HL) in the United States. This study seeks to investigate provider perspectives on evaluating, counseling, and treating HL in LEP patients.

Study design: Prospective descriptive study.

Setting: Tertiary care center.

Methods: Researchers employed a mixed methods design: (1) structured clinician interviews, (2) cross-sectional, national electronic survey, both regarding perspectives on managing hearing loss in LEP patients. Structured interviews were analyzed using modified grounded theory.

Results: Twenty-nine providers participated in interviews (16 otologists, 13 audiologists). The most reported non-English language was Spanish, followed by Chinese languages. Four thematic domains were derived: barriers to care, cochlear implant (CI) candidacy evaluation, counseling, and ideal resources. Major barriers were patient desire (97%; n = 28), and lack of validated tests (72%; n = 21). Methods of CI evaluation included improvising on validated speech perception testing (59%; n = 17) and use of non-speech evaluation (52%; n = 15). One-quarter forgoes speech testing in non-Spanish-speaking patients (24%; n = 7). Suggestions to improve management include in-person interpreters (62%; n = 18) and testing battery in all languages (31%; n = 9). National survey results (n = 87 providers) demonstrated that respondents were significantly less confident in the methods of speech perception testing and in counseling on surgical hearing rehabilitation in LEP.

Conclusion: Clinicians encounter challenges in managing LEP patients with HL, including limitations in audiometric and CI candidacy assessment, communication barriers, information accessibility, and cultural competency. Opportunities for improving care include developing language-specific test batteries, linguistically and culturally appropriate education materials, and cultural competency training.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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