Communication Barriers

沟通障碍
  • 文章类型: Journal Article
    当每个人都有平等的机会实现其最高水平的健康时,就存在健康公平。有效的沟通对于确保治疗关系至关重要。英语水平有限(LEP)的患者遇到沟通障碍,导致较差的结果。联邦法规要求医院提供受过医学培训的口译员;但是,这并不总是发生。我们确定了三个广泛的研究领域:沟通障碍,结果,和成本。研究结果强调了LEP患者在医疗保健系统中面临的挑战,以及需要有针对性的干预措施来加强语言的获取,提高卫生保健专业人员的文化能力,并确保所有人的公平结果。
    Health equity exists when everyone has an equal opportunity to achieve their highest level of health. Effective communication is essential to ensure a therapeutic relationship. Patients with limited English proficiency (LEP) experience communication barriers, leading to poorer outcomes. Federal regulation requires hospitals to provide medically trained interpreters; however, this does not always occur. We identified 3 broad areas of research: communication barriers, outcomes, and costs. Findings highlight the challenges patients with LEP face in the health-care system, and the need for targeted interventions to enhance language access, improve cultural competence among health-care professionals, and ensure equitable outcomes for all.
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  • 文章类型: Journal Article
    背景:估计有220万来自中欧和东欧(CEE)的人居住在英国。有记录表明,中欧和东欧移民在英国未充分利用卫生服务,作为替代,在他们的祖国寻求医疗保健。然而,在国外寻求医疗保健的原因并不总是很清楚。这篇综述旨在确定居住在英国的CEE移民采用跨国医疗保健的原因。
    方法:通过与社区成员的讨论,医疗利益相关者和学者,在乔安娜·布里格斯研究所范围审查的九阶段框架之后,进行了系统的范围审查。带有MeSH术语的搜索策略,如果相关,在五个学术数据库中使用和改编,两个灰色文献数据库和谷歌学者。包含的记录包含四个概念:迁移,CEE国籍,英国国家和医疗保健利用,这是用英文写的,并在2004年5月至2022年之间出版。文献中的数据被编码,分组并组织成主题。
    结果:共有16篇出版物符合纳入标准。有证据表明,一些CEE移民只使用英国的医疗保健服务。然而,许多CEE移民在英国及其原籍国都使用医疗保健。从文献中确定了四个主题,即为什么移民前往原籍国寻求医疗保健:对医疗服务的文化期望,对英国NHS的不信任,壁垒和跨国联系。
    结论:推动因素导致CEE移民在其原籍国寻求医疗保健,在持续的跨国关系的推动下。CEE移民经常将对原籍国的访问与医疗预约相结合。在其原籍国使用医疗保健而不是在英国使用医疗保健可能会导致药物记录分散和不完整,医学检查和手术以及不必要的治疗和并发症的风险。这项审查强调需要与联合王国境内的CEE团体进行更有针对性的卫生外联,以及需要进一步研究国家事件的影响,例如,COVID-19和英国退欧,关于跨国寻求医疗保健的行为。
    这个范围审查的概念是通过与社区成员的讨论得出的,医学专家和学者,他认为这是一个当前的问题。与医疗保健利益相关者讨论了本次范围审查的结果。
    BACKGROUND: An estimated 2.2 million people from Central and Eastern Europe (CEE) live in the United Kingdom. It has been documented that CEE migrants underutilise health services in the United Kingdom and, as an alternative, seek healthcare in their home country. However, reasons for seeking healthcare abroad are not always clear. This review aims to identify the reasons for the uptake of transnational healthcare among CEE migrants resident in the United Kingdom.
    METHODS: Informed by discussions with community members, medical stakeholders and academics, a systematic scoping review was undertaken following the nine-stage Joanna Briggs Institute framework for scoping reviews. A search strategy with MeSH terms, where relevant, was used and adapted in five academic databases, two grey literature databases and Google Scholar. Included records encompassed four concepts: migration, CEE nationalities, UK nations and healthcare utilisation, which were written in English and published between May 2004 and 2022. Data from the literature were coded, grouped and organised into themes.
    RESULTS: A total of 16 publications fulfilled the inclusion criteria. There is evidence that some CEE migrants exclusively use healthcare services in the United Kingdom. However, many CEE migrants utilise healthcare both in the United Kingdom and their country of origin. Four themes were identified from the literature as to why migrants travelled to their country of origin for healthcare: cultural expectations of medical services, distrust in the UK NHS, barriers and transnational ties.
    CONCLUSIONS: Push factors led CEE migrants to seek healthcare in their country of origin, facilitated by ongoing transnational ties. CEE migrants frequently combine visits to their country of origin with medical appointments. Utilising healthcare in their country of origin as opposed to the United Kingdom can result in fragmented and incomplete records of medications, medical tests and surgeries and risk of unnecessary treatments and complications. This review highlights the need for more targeted health outreach with CEE groups within the United Kingdom, as well as the need for further research on the impact of national events, for example, COVID-19 and Brexit, on transnational healthcare-seeking behaviours.
    UNASSIGNED: The concept for this scoping review was informed by discussions with community members, medical professionals and academics, who identified it as a current issue. The results of this scoping review were discussed with healthcare stakeholders.
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  • 文章类型: Journal Article
    美国每四个孩子中就有一个在移民家庭中长大,在移民家庭中,55%的孩子的父母说英语和懂英语的程度低于“非常好”。尽管针对移民家庭儿童(CIF)的研究数量有所增加,CIF,特别是那些以英语(LOE)以外的语言进行交流的人经常被排除在研究之外。我们回顾了2017-2023年在PubMed中的“移民家庭和美国儿童”研究,并将其归类为定性的,定量,混合方法或社区参与研究。我们审查了观察结果并为研究提供了建议,以促进移民家庭中儿童的健康和福祉,包括:使用基于优势的框架;优先考虑使用英语以外的语言的家庭;修改定性研究的报告标准,以包括研究团队和研究参与者彼此讲不同语言的项目的报告方法指南;并在大型国家调查和队列研究中纳入识别经历过移民的人的方法。我们建议对CIF进行包容性研究,以考虑跨部门合作的其他增长领域,干预措施和临床试验,以及对调查人员的培训和支持。
    One in four children in the US grow up in immigrant families, and 55% of children in immigrant families have a parent who speaks and understands English less than \"very well\". While the number of research studies that is focused on children in immigrant families (CIF) has increased, CIF particularly those that communicate in a language other than English (LOE) are frequently excluded from research. We reviewed studies including \"children in immigrant families and the United States\" in PubMed from 2017-2023, and categorized them as qualitative, quantitative, mixed-methods or community engaged research. We review observations and offer recommendations for research to promote the health and well-being of children in immigrant families including: using strengths-based frameworks; prioritizing the inclusion of families who speak languages other than English; amending reporting standards for qualitative studies to include guidance on reporting methods for projects in which research teams and study participants speak different languages from one another; and incorporating methods to identify people who have experienced migration in large national surveys and cohort studies. We recommend research with and inclusive of CIF to consider additional areas for growth in cross-sector collaborations, interventions and clinical trials, and training and support for investigators.
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  • 文章类型: Systematic Review
    背景:全球对姑息治疗(PC)的需求正在增加,尤其是随着人口老龄化。威胁生命的疾病的诊断引发了医疗保健专业人员(HCP)的许多决定。这些专业人员如何理解和处理PC会影响向患者提供的护理的数量和质量。本系统综述旨在比较世界各地HCP对PC的看法。
    方法:数据库(MEDLINE/PubMed,Embase,LILACS,和EBSCO)进行了系统搜索。报告对HCPs的看法的文章,2012年1月至2022年12月期间发布的,包括在内。报道家庭成员和患者看法的文本被排除在外,以避免偏见的风险。这些报告是按国家/地区和大陆组织的,供以后分析。
    结果:在最初检索的2,063篇文章中,有32篇被收录并提供了来自四大洲的相关信息(美国,亚洲,欧洲,和大洋洲)。其中大部分是通过访谈和问卷调查完成的。研究中咨询的所有HCP都认识到PC的重要性。这些专业人士的认知受到文化因素(如宗教)的影响,在每个国家/地区感知到的困难(如知识不足,概念混乱,等。),疾病,和患者的年龄范围。专业人士在日常工作中处理此主题的接受和准备也影响了他们对HCPs的看法。这项研究的局限性在于缺乏来自非洲的合格研究以及一些研究的参与者人数很少。
    结论:可以得出结论,HCP对PC的看法相似,不管他们的原籍国。
    BACKGROUND: The global need for palliative care (PC) is increasing, especially as the population ages. The diagnosis of a life-threatening illness triggers numerous decisions by healthcare professionals (HCPs). How these professionals understand and deal with PC influences the quantity and quality of care provided to patients. This systematic review aimed to compare perceptions of PC among HCPs around the world.
    METHODS: The databases (MEDLINE/PubMed, Embase, LILACS, and EBSCO) were searched systematically. Articles reporting on the perception of HCPs, published between January 2012 and December 2022, were included. Texts that reported the perceptions of family members and patients were excluded to avoid the risk of bias. Those included were organized by country/region and continent for later analysis.
    RESULTS: Of the 2,063 articles initially retrieved 32 were included and provided relevant information from four continents (America, Asia, Europe, and Oceania). Most of this was done through interviews and questionnaires. All HCPs consulted in the studies recognized the importance of PC. The perception of these professionals was influenced by cultural factors (such as religion), difficulties perceived in each country/region (such as inadequate knowledge, conceptual confusion, etc.), diseases, and the age range of patients served. The acceptance and preparation of professionals to deal with this topic in their routine also influenced their perceptions of HCPs. The limitation of this research is the lack of eligible studies from Africa and the small number of participants in some studies.
    CONCLUSIONS: It can be concluded that HCPs\' perceptions of PC are similar, regardless of their country of origin.
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  • 文章类型: Journal Article
    背景:痴呆作为一种神经认知障碍在世界范围内变得越来越普遍,少数群体比一般人口更脆弱。许多因素可能导致他们的脆弱性,如误解,语言障碍,文化因素,无效的评估工具,缺乏知识或将精神信仰赋予痴呆症状。因此,这篇范围界定的文献综述旨在阐明实证研究如何反映痴呆症的含义,语言,和少数民族之间的翻译。
    结论:使用范围审查方案的PRISMA扩展。对38项以英文发表的研究进行了回顾和分析。研究结果表明,在少数群体中,经常缺乏有关痴呆症的知识,并将疾病归因于正常的衰老过程。此外,他们对健康和幸福的文化特定观点和世界观会影响痴呆症的感知方式,随之而来的求助行为,或照顾。促进教育计划以增强种族社区的知识和经验可能是有益的。此外,语言被证明是痴呆症评估的一个重要方面,参与者的教育水平可能会显著影响他们在应对认知措施时的功能能力。即使有一些有用的筛查测试,诊断障碍可能会通过评估工具的开发来缓解,修改,和种族社区的准确翻译。
    结论:支持不同种族的痴呆症社区的一个有希望的途径是提高人们的认识,提供特定种族的服务,开发特定文化的工具,通过考虑认知来评估痴呆症或任何认知障碍,语言,和民族之间的文化。文化和精神考虑也可以鼓励评估期间的参与。
    BACKGROUND: Dementia as a neurocognitive disorder is becoming increasingly common worldwide, and minority groups are more vulnerable than the general population. Many factors may contribute to their vulnerability such as misconceptions, language barriers, cultural factors, invalid assessment tools, lack of knowledge, or assigning spiritual beliefs to dementia symptoms. Therefore, this scoping literature review aimed to clarify how empirical studies reflect the meaning of dementia, language, and translation among minority ethnic groups.
    CONCLUSIONS: The PRISMA extension for the scoping review protocol was used. Thirty-eight studies published in English were reviewed and analysed. The findings revealed that lack of knowledge about dementia and attributing the disease to the normal ageing process were frequent among minority groups. Furthermore, their cultural-specific perspectives and worldviews of wellness and well-being can impact the way dementia is perceived, consequent help-seeking behaviours, or caregiving. Facilitating educational programs to enhance the knowledge and experiences of ethnic communities might be beneficial. Moreover, language is shown to be an important aspect in dementia assessment and participants\' educational level could significantly impact their functional capacity when responding to cognitive measures. Even though there are some useful screening tests, diagnosis barriers might be eased by assessment tool development, modifications, and accurate translations for ethnic communities.
    CONCLUSIONS: A promising pathway to support ethnically diverse communities regarding dementia can be raising awareness, providing ethnic-specific services, developing cultural-specific tools to assess dementia or any cognitive impairment by considering perceptions, language, and culture among ethnic groups. Cultural and spiritual considerations could also encourage engagement during assessment.
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    文章类型: Journal Article
    语言障碍会严重影响患者与医护人员之间的沟通,并与接受低质量护理有关。注册护士是医疗保健团队中处于有利地位的成员,可以减少和消除英语水平有限(LEP)患者的差距。目前的证据建议护士使用口译员或翻译设备来克服语言障碍;然而,这些建议没有认识到结构系统层面的因素,如缺乏支持性的工作环境和护士与病人的人员配备比例差,降低护士实施这些建议的能力。质量健康结果模型(QHOM)是理解医院系统之间关系的有用框架。提供护理干预措施,和患者结果。本手稿的目的是利用QHOM和现有的经验证据,通过考虑护士提供患者护理的背景,为减少与语言相关的健康结果差异的长期临床挑战提出新的观点。
    Language barriers significantly affect communication between patients and health care staff and are associated with receipt of lower-quality care. Registered nurses are well positioned members of the health care team to reduce and eliminate disparities for patients with limited English proficiency (LEP). Current evidence recommends nurses use interpreters or translation devices to overcome language barriers; however, these recommendations fail to recognize that structural system-level factors, such as unsupportive work environments and poor nurse-to-patient staffing ratios, reduce nurses\' ability to implement these recommendations. The Quality Health Outcomes Model (QHOM) is a useful framework for understanding relationships between hospital systems, the delivery of care interventions, and patient outcomes. The goal of this manuscript is to use the QHOM and existing empirical evidence to present a new perspective on the long-standing clinical challenge of reducing language-related health outcome disparities by considering the context in which nurses deliver patient care.
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  • 文章类型: Journal Article
    这篇综述调查了南蒂罗尔的疫苗犹豫,意大利,以文化和语言多样性为特征的地区。疫苗接种控制传染病的迫切需要与该地区的低接种率形成对比,这构成了重大的公共卫生挑战。
    根据文献,reports,和研究,我们用PubMed,Embase,和谷歌学者在南蒂罗尔探索疫苗犹豫。它强调历史的分析,文化,和社会经济因素,并侧重于定量调查和定性访谈,以了解疫苗犹豫的根源。
    在两项有四份报告的研究中,对卫生政策和机构的不信任,错误信息,文化和语言障碍被认为是导致南蒂罗尔疫苗犹豫的关键因素。该地区独特的社会政治格局加剧了这些因素,这影响了公共卫生政策和疫苗接种计划。
    这些发现突出了针对南蒂罗尔的公共卫生战略的必要性。建议采取的行动包括开展文化敏感和多语言的交流运动,增加社区参与,重建对医疗系统的信任。这些方法对于解决南蒂罗尔的具体挑战至关重要,从而提高疫苗的摄入量和整体公共卫生结果。
    UNASSIGNED: This review examines vaccine hesitancy in South Tyrol, Italy, a region characterized by cultural and linguistic diversity. The critical need for vaccination to control infectious diseases contrasts with the region\'s low vaccination rates, which pose a significant public health challenge.
    UNASSIGNED: Based on literature, reports, and studies, we used PubMed, Embase, and Google Scholar to explore vaccine hesitancy in South Tyrol. It emphasizes the analysis of historical, cultural, and socioeconomic factors, and focuses on quantitative surveys and qualitative interviews to understand the roots of vaccine hesitancy.
    UNASSIGNED: In two studies with four reports, mistrust in health policies and institutions, misinformation, and cultural and linguistic barriers were identified as key factors contributing to vaccine hesitancy in South Tyrol. These factors are accentuated by the region\'s unique sociopolitical landscape, which influences public health policies and vaccination initiatives.
    UNASSIGNED: These findings highlight the need for public health strategies specifically tailored to South Tyrol. Recommended actions include developing culturally sensitive and multilingual communication campaigns, increasing community involvement, and rebuilding trust in healthcare systems. These approaches are essential for addressing the specific challenges in South Tyrol, thereby improving vaccine uptake and overall public health outcomes.
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  • 文章类型: Journal Article
    背景:在全球许多医疗保健环境中,护理提供者和患者的语言不匹配,沟通错误或不沟通可能导致诊断不准确和治疗结果不佳.为了弥合这些语言障碍,使用了一系列非正式的做法,如家庭成员或担任口译员的工作人员,“接受多语种”或机器翻译。技术工具的开发和使用日益增多,但是复杂的健康相关文本的翻译质量等因素因语言而异。此范围审查的目的是(1)识别和描述直接患者与提供者沟通中使用的技术工具,以克服医疗保健环境中的语言障碍,(2)确定如何评估这些工具的可用性,以及(3)评估技术工具的可用性。
    方法:范围审查将遵循JoannaBriggs研究所的方法。使用关键字“技术工具”变体的搜索策略,“语言障碍”和“医疗保健”将应用于以下数据库和研究平台:PubMed,PsycArticle,Scopus,EBSCOhost,ProQuest和WebofScience所有个人使用技术工具来克服医疗保健环境中的语言障碍的文献都将包括在内,并导出到筛查助手软件Rayyan中。搜索将仅限于用德语或英语撰写的文章。两名独立的审稿人将筛选文章,所有提取的相关数据将以描述性摘要的形式呈现。
    背景:此范围审查不需要道德批准,因为这项研究的方法包括从公开来源收集数据。调查结果将通过开放获取的出版物传播,同行评审的期刊和科学会议上的演讲。范围审查结果还将指导跨国项目的未来研究,该项目调查了向移民提供(精神)医疗保健的多种语言。
    BACKGROUND: In many healthcare contexts globally, where the languages of care providers and patients do not match, miscommunication or non-communication can lead to inaccurate diagnoses and subpar treatment outcomes. In order to bridge these language barriers, a range of informal practices are used, such as family members or staff acting as interpreters, \'receptive multilingualism\' or machine translation. The development and use of technological tools are increasing, but factors such as translation quality for complex health-related texts vary widely between languages. The objective of this scoping review is to (1) identify and describe the technological tools used in direct patient-provider communication to overcome a language barrier in a healthcare setting, (2) identify how the usability of these tools was evaluated and (3) assess the usability of the technological tools.
    METHODS: The scoping review will follow the Joanna Briggs Institute methodology. A search strategy using variations of the keywords \'technological tools\', \'language barrier\' and \'healthcare\' will be applied in the following databases and research platforms: PubMed, PsycArticle, Scopus, EBSCOhost, ProQuest and Web of Science. All literature where individuals use a technological tool to overcome a language barrier in a healthcare context will be included and exported into the screening assistant software Rayyan. The search will be limited to articles written in German or English. Two independent reviewers will screen the articles, and all relevant extracted data will be presented in a descriptive summary.
    BACKGROUND: This scoping review does not require ethical approval, as the study\'s methodology consists of collecting data from publicly available sources. The findings will be disseminated through publication in an open-access, peer-reviewed journal and presentations at scientific conferences. The scoping review results will also guide future research in a multinational project investigating multilingualism in providing (mental) healthcare to migrants.
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  • 文章类型: Systematic Review
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:我们旨在系统回顾和荟萃分析已发表的关于医疗保健专业人员和听力损失患者之间沟通方式的证据。
    方法:MEDLINE/PubMed,Scopus,CINAHL,ScienceDirect,和泰国期刊在线完整数据库进行了搜索。使用随机效应模型进行荟萃分析。提取了有关医疗保健专业人员与任何程度的听力损失患者之间的患病率和沟通类型的数据。
    结果:纳入20项研究。使用助听器(合并患病率,57.4%;95%CI,11.4%-103.4%,N=3,I2=99.33)和手势(合并患病率=54.8%,95CI:17.4%至92.1%,N=7,I2=99.68)是最常见的通信方式。很少有医疗保健专业人员会使用手语,有限的机会获得合格的口译员是常见的。
    结论:存在沟通障碍。应使用合格的手语翻译和辅助技术来改善交流。
    OBJECTIVE: We aimed to systematically review and meta-analyze published evidence on modes of communication between healthcare professionals and patients with hearing loss.
    METHODS: MEDLINE/PubMed, Scopus, CINAHL, ScienceDirect, and Thai Journals Online Complete databases were searched. A meta-analysis was performed using a random-effects model. Data on the prevalence and types of communication between healthcare professionals and patients with any extent of hearing loss were extracted.
    RESULTS: Twenty studies were included. Using a hearing aid (pooled prevalence, 57.4%; 95% CI, 11.4%-103.4%, N = 3, I2 = 99.33) and gestures (pooled prevalence = 54.8%, 95%CI: 17.4% to 92.1%, N = 7, I2 = 99.68) were the most commonly reported modes of communication. Few healthcare professionals could use sign language, and limited access to qualified interpreters was common.
    CONCLUSIONS: Communication barriers exist. Qualified sign language interpreters and assistive technology should be used to improve communication.
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  • 文章类型: Journal Article
    目标:在2019年,22%的美国成年人报告说在家里说英语以外的语言,自2000年以来增长了52%。这种语言的多样性——以及由此产生的可能的沟通障碍——代表了对有效护理的潜在挑战。在这份手稿中,我们总结了非英语主要语言使用者(NEPLS)的成人和儿童神经外科患者的临床结局和医疗保健利用模式.
    方法:从成立到2022年10月,我们系统地查询了五个数据库。遵循系统审查和荟萃分析指南的首选报告项目,以确定纳入研究。纽卡斯尔-渥太华量表用于评估研究质量。此外,我们进行了回顾性图表回顾,以评估我们机构的一组讲英语和西班牙语的颅骨融合患者术后沟通方式的差异.
    结果:我们的搜索产生了442篇摘要;最终队列中包括了10篇。包括973种具有神经外科疾病的独特NEPLS的结果;西班牙语是最具代表性的语言。手术治疗的交付和时机是最常报告的指标;75%的研究表明,手术时间有统计学意义的延迟或NEPLS接受手术治疗的可能性降低。在三项研究中报告了住院时间(LOS);所有这些都表明NEPLS的LOS更长。
    结论:报告NEPLS结果的文献很少。检查NEPLS患者的结果和经验至关重要,因为语言障碍是潜在的可改变的人口因素。我们提出了一个框架,展示了进一步研究以提高护理质量的机会。
    In 2019, 22% of adults in the United States reported speaking a language other than English at home, representing 52% growth since 2000. This diversity in languages - and resulting possible communication barriers - represents a potential challenge to effective care. In this manuscript, we summarize clinical outcomes and healthcare utilization patterns of adult and pediatric neurosurgical patients who are non-English primary language speakers (NEPLS).
    We systematically queried 5 databases from inception through October 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to identify studies for inclusion. The Newcastle-Ottawa Scale was used to assess the quality of studies. Additionally, a retrospective chart review was conducted to assess differences in postoperative communication patterns in a cohort of English and Spanish speaking patients with craniosynostosis at our institution.
    Our search yielded 442 abstracts; ten were included in the final cohort. Outcomes for 973 unique NEPLS with a neurosurgical condition were included; Spanish was the most represented language. Delivery and timing of surgical treatment was the most frequently reported metric; 75% of studies demonstrated a statistically significant delay in time to surgery or decreased likelihood for NEPLS to receive surgical treatment. Length of stay was reported in 3 studies; all demonstrated that NEPLS had longer length of stay.
    There is a paucity of literature reporting outcomes among NEPLS. It is critical to examine NEPLS patients\' outcomes and experiences, as language barriers are potentially modifiable demographic factors. We present a framework that demonstrates opportunities for further research to improve quality of care.
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