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Semelhante a Communication with Latino Patients--Improving Medical and Nursing Education
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Communication with Latino Patients--Improving Medical and Nursing Education
- 1. COMMUNICATION WITH LATINO PATIENTS— IMPROVING MEDICAL AND NURSING EDUCATION Rachel Mayo, Windsor Sherrill, Sarah Griffin, Caroline Swiger, Jessica Meehan, Taylor Hughes, Janet Evatt, Veronica Parker* Department of Public Health Sciences *Department of Nursing Clemson University Clemson, South Carolina
- 3. SIGNIFICANT CHANGE NATIONALLY IN THE SOUTHEAST
- 4. NATIONAL GROWTH IN THE LATINO POPULATION LARGEST CHANGE IN LATINO POPULATION, BY STATE (U.S. Census Bureau, 2010) Latino Non-Latino White Total Nation 2010 2000 2010 2000 2010 2000 Percent of total population (%) 16.3 12.5 63.7 69.1 -- -- Percent Growth (%) 43.0 1.2 9.7 State Percent Change (%), 2000-2010 Rank in Nation South Carolina 148 1 Georgia 96 11 North Carolina 111 6 Tennessee 134 3
- 9. HOW TO ADDRESS THE COMMUNICATION CHALLENGE Improved readiness to treat Latino patients
- 16. LIKERT SCALE: PILOT SURVEY
- 20. FOCUS GROUPS
- 21. FOCUS GROUPS
- 24. PILOT SURVEY RESULTS: N=99 MEDICAL AND NURSING STUDENTS Key: Responses: 1-4 scale H/L=Hispanic/Latino Survey Question N Minimum Maximum Mean Standard Deviation Please indicate to what extent you agree or disagree: I am able to explain treatment options and clinical trials to H/L patients. 97 1 4 2.67 0.673 As a provider, I feel able to provide satisfactory rapport with H/L patients. 96 1 4 2.84 0.670 In providing clinical care, I will avoid speaking to H/L families because of language barriers. 98 1 4 1.54 0.691 A patient’s cultural background can make it difficult to conduct an adequate clinical assessment. 96 1 4 2.84 0.670
- 25. PILOT SURVEY RESULTS: N=99 MEDICAL AND NURSING STUDENTS Key: Responses: 1-5 scale H/L=Hispanic/Latino Survey Question N Minimum Maximum Mean Standard Deviation Based on your training and experience, please rate your skill level in the following aspects of care for H/L patients: Communicating effectively through a healthcare interpreter. 98 1 4 2.93 0.763 Based on your training and experience, please rate your skill level in the following aspects of care for H/L patients: Determining patients’ communication preferences. 99 1 4 2.93 0.659
- 30. QUESTIONS?
Notas do Editor
- Workforce not diverse, patient populations diverse* 1-low disagreement, 4-high Separate likert and i-s
- As you all know, the ethnic group that we refer to as Hispanic or Latino has had major population growth in the last 10-20 years. Before we go too far, I’d like to discuss that terminology for a moment. The phrase Hispanic is a Census term. This particular group doesn’t really prefer that descriptor and they don’t self-reference that way. For that reason, we choose to use Latino. However, our participants are not the patients but are student providers. Because most literature uses “Hispanic”, we found that Hispanic/Latino was the best, most understandable phrase to use in our project. The individual terms will be used interchangeably in the presentation, but that is what we prefaced and defined in the survey. Another note—we recognize the diversity that this ethnic group presents, and that it can mean different things to different communities. However, in the Southeast, the Latino community is quite uniform. Our target population is predominantly Mexican and generally underserved in healthcare. That is the group that we referred to and our participants understood that. Pay attention to what is happening nationally. Shades of blue=20-100+% change. National trend. Southeast region=denser percent change, more dark blue.
- The Latino population in the US has been rapidly expanding. Latinos account for 56% of total national growth, 2000-2010, US Census Bureau Under-reported: more Latinos claiming “white” or “some other race” on 2010 U.S. Census, The Beacon-News States with the largest percent change: SC=#1
- Major policy makers and institutions, including IOM and CDC, are recognizing disparities in healthcare concerning Latinos.
- Read.
- Improved cultural competency skills will improve communication skills with Latino patients. How to improve cultural competency? Exposure/experience and education at the undergraduate and graduate level. Our study is interested in interventions at the educational level.
- We want to assess current readiness to treat Latino patients in student providers (medical and nursing). Once evaluated, educational interventions can be designed to improve cultural competence and communication skills and thus enhance the student provider readiness to treat Latino patients, which will hopefully reduce disparities.
- Theoretical framework used to measure current student provider readiness to treat Latino patients—indices employed in MaNSRT survey.
- We are trying to identify gaps in the care of Latino patients, especially in medical and nursing education. Communication is a huge gap. If identified, we can develop interventions to close those gaps, including with communication. The gap is not just linguistic. Cultural competence is the gap (language is just one of those skills).
- LESS TIME< GET TO QUESTIONS One particular area of revision: Much recent opinion among survey researchers has focused on the potential problems associated with Likert scales, particularly respondent acquiescence, or the tendency for respondents to agree with attitude statements. Working with our survey expert, we attempted to devise questions and scales with greater discriminatory power than the standard Likert scale.
- Revisions, pilot process Changes between pilot and final, changes in likert to is Examples, why important Much recent opinion among survey researchers has focused on the potential problems associated with Likert scales, particularly respondent acquiescence, or the tendency for respondents to agree with attitude statements. Working with our survey expert, we attempted to devise questions and scales with greater discriminatory power than the standard Likert scale.
- Pilot survey: Likert scale, 1-4 response scale
- Final survey: Item-specific question, 1-5 response scale Measuring skill sets (Student provider language and experience index) *Read questions
- Item-specific Measuring cultural familiarity (Student Provider Knowledge Index)
- Item-specific Measuring student provider opinions on Latinos (Student Provider Psychological Index)
- Now we will give some feedback on what students are saying about their experiences with Latinos, their perceptions on the communication challenge, and their opinions on their cultural competence training.
- About communication Themes Nurses and medical students Any provider
- If the student providers feel comfortable, they won’t see them as something separate (which they do now).
- Survey comparisons, pull out communication Questions from current survey on communication LIKERT SCALE vs. IS **1-4 scale
- Survey comparisons, pull out communication Questions from current survey on communication LIKERT SCALE vs. IS
- IMPORTANT, EXPLAIN WELL Variable ability– between agree-disagree Lacking confidence in communication skills and interpreter use when caring for Latino patients
- Speak afterwards, exchange cards