Abstract：
Language-based disparities negatively impact patient outcomes. Spanish-speaking Latino patients with traumatic brain injury (TBI) transitioning home from acute hospital care and their families have poor TBI-related outcomes; further, they have significant difficulties navigating the healthcare system due to care fragmentation and limited provider support. These challenges are exacerbated by language barriers. There are disproportionately fewer bilingual providers and interpreters in the U.S. healthcare system for patients with TBI for whom English is not their primary language. Although Spanish-speaking Latino patients with TBI and their families communicate with healthcare providers using interpreters on a regular basis, limited research has explored the healthcare delivery perspective. The purpose of this study was to understand the perspectives of healthcare providers and interpreters regarding their experience caring for or supporting Spanish-speaking Latino patients with TBI and their families during the transition home from acute hospital care. This qualitative descriptive study included 10 bilingual (English and Spanish-speaking) participants: 7 interdisciplinary providers and 3 interpreters; findings were analyzed using rapid qualitative analysis to inform intervention adaptation. Four themes were identified: 1) language misalignment decreases health literacy and increases length of stay; 2) TBI-related cognitive impairments, coupled with language differences, make communication challenging; 3) unique social contributors to health directly decrease health equity; and 4) recommendations to improve access and justice in transitional care. There are multiple opportunities to improve transitional care support provided to Spanish-speaking Latino patients with TBI and their families in a manner that is not currently being addressed in research or in practice.
摘要：
基于语言的差异对患者预后产生负面影响。讲西班牙语的拉丁裔创伤性脑损伤（TBI）患者从急性医院护理转移回家，他们的家人有较差的TBI相关结果;进一步，由于护理分散和提供者支持有限,他们在医疗保健系统中存在很大困难.语言障碍加剧了这些挑战。对于英语不是他们的主要语言的TBI患者，美国医疗保健系统中的双语提供者和口译员少得多。尽管讲西班牙语的拉丁裔TBI患者及其家人定期使用口译员与医疗保健提供者进行交流，有限的研究探索了医疗保健提供的观点。这项研究的目的是了解医疗保健提供者和口译员在从急性医院护理过渡回家期间照顾或支持讲西班牙语的拉丁裔TBI患者及其家人的经验的观点。这项定性描述性研究包括10名双语（英语和西班牙语）参与者：7名跨学科提供者和3名口译员；使用快速定性分析对结果进行分析，以告知干预适应。确定了四个主题：1）语言失调会降低健康素养并增加住院时间；2）与TBI相关的认知障碍，加上语言差异，使沟通具有挑战性；3）对健康的独特社会贡献者直接降低了健康公平性；4）改善过渡护理的获取和公正的建议。有多种机会以目前在研究或实践中尚未解决的方式改善向讲西班牙语的拉丁裔TBI患者及其家人提供的过渡护理支持。
