Aparna Govindan, Adina Singer, Lily Zekavat, Tianyi Jia, Kevin Wong, Jianjing Kuang, Maura K Cosetti, Tiffany P Hwa
{"title":"临床医师对英语水平有限患者听力损失处理的看法。","authors":"Aparna Govindan, Adina Singer, Lily Zekavat, Tianyi Jia, Kevin Wong, Jianjing Kuang, Maura K Cosetti, Tiffany P Hwa","doi":"10.1002/ohn.1089","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Study design: </strong>Prospective descriptive study.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1232-1241"},"PeriodicalIF":2.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinician Perspectives on the Management of Hearing Loss in Patients With Limited English Proficiency.\",\"authors\":\"Aparna Govindan, Adina Singer, Lily Zekavat, Tianyi Jia, Kevin Wong, Jianjing Kuang, Maura K Cosetti, Tiffany P Hwa\",\"doi\":\"10.1002/ohn.1089\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Study design: </strong>Prospective descriptive study.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":19707,\"journal\":{\"name\":\"Otolaryngology- Head and Neck Surgery\",\"volume\":\" \",\"pages\":\"1232-1241\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Otolaryngology- Head and Neck Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ohn.1089\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1089","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
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.
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.