Information Visualization to Improve Pain Communication Between Providers, Interpreters, and Patients with Limited English Proficiency

信息可视化可改善提供者、口译员和英语水平有限的患者之间的疼痛沟通

• 批准号: 10269938
• 负责人: Maichou Lor
• 金额: $ 15.99万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-25 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10269938
• 关键词: Address; Area; Caring; Chinese People; Color; Communication; Communication Tools; Communities; Comprehension; Data; Data Collection; Descriptor; Development; Diagnosis; Environment; Evaluation; Face; Familiarity; Foundations; Goals; Individual; Intervention; Intervention Studies; Interview; Knowledge; Language; Latino; Lead; Limited English Proficiency; Linguistics; Location; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Metaphor; Methodology; Outcome; Outcome Measure; Pain; Pain Measurement; Pain interference; Pain management; Participant; Patient-Focused Outcomes; Patients; Perception; Population; Primary Health Care; Procedures; Provider; Quality of life; Reporting; Research; Research Personnel; Science; Severities; Statistical Methods; Suggestion; Symptoms; Terminology; Testing; Thermometers; Training; Translating; Triad Acrylic Resin; Universities; Visual; Visualization; Visualization software; Vulnerable Populations; Wisconsin; Writing; career; comparison group; design; efficacy study; experience; health disparity; improved; innovation; insight; negative affect; pain outcome; pain relief; pain scale; patient oriented research; patient-clinician communication; primary care setting; programs; recruit; response; retention rate; satisfaction; skills; southeast Asian; symptom management; symptom science; symptomatic improvement; tool; treatment as usual

Abstract Communication differences between patients, interpreters, and providers contribute to health disparities, especially for U.S. populations with limited English proficiency (LEP; defined as being unable to read, write, or speak English), in the context of pain. Currently, no patient-interpreter-provider pain communication interventions exist to address LEP patient culture and language barriers in pain reporting. My career goal is to establish an independent patient-oriented research program that focuses on designing, implementing, and testing information visualization (InfoViz) tools to improve symptom communication among LEP patients, interpreters, and providers, with the goal of ultimately improving quality of life and reducing health disparities. This K23 award will provide me with advanced skills in (1) InfoViz evaluation, (2) symptoms (pain) science, (3) intervention research, and (4) professional development to successfully transition into an independent investigator. The research environment at the University of Wisconsin–Madison and the interdisciplinary mentoring team including Drs. Kristine Kwekkeboom (pain and symptom management, intervention research), Suzanne Bakken (information visualization evaluation), Toby Campbell (patient-provider communication), Roger Brown (statistical methods), and David Rabago (pain, primary care), provide an exceptional scientific environment and mentorship. The purpose is to modify and conduct a pilot test of a tailored pain assessment InfoViz tool to facilitate patient-interpreter-provider triad communication of pain severity, location, and quality to increase mutual understanding (MU) during pain assessment. LEP Hmong will be the focus of this study because pain is particularly problematic for this group; they describe pain using visual metaphors that are inconsistent with providers’ knowledge and interpreters struggle to translate metaphors accurately between patients and providers. This innovative InfoViz tool will reduce cultural and language barriers among the triad by (1) eliminating the need for patients to understand medical language or requiring providers and interpreters to share the Hmong culture and language and (2) reducing the amount of skill needed for interpreting. The specific aims are (1) to evaluate the pain assessment InfoViz tool via a participatory design approach with 45 Hmong patients (n = 30) and interpreters (n = 15) from the community; and (2) to pilot the pain assessment InfoViz tool among LEP Hmong patients in primary care including (2a) to examine the feasibility of implementing the tool, (2b) to explore congruency of the triads’ MU of pain severity, location, and quality, and (2c) to evaluate outcome measures selected to capture satisfaction with communication, pain relief, and pain interference and explore variables identified in the InfoViz tool conceptual framework. Aim 2 will use a static group comparison design, collecting data from 20 patients under the usual care (i.e., interpreters using verbal pain descriptions), followed by data collection from another 20 patients under the intervention condition (i.e., interpreters using verbal descriptions and the InfoViz tool). Findings will support an R01 efficacy study.

抽象的 患者，口译员和提供者之间的沟通差异有助于健康分布， 特别是对于英语水平有限的美国人口（LEP；定义为无法阅读，写作或 在痛苦的背景下说英语）。目前，没有病人互动的疼痛交流 存在干预措施，以解决LEP患者文化和疼痛报告中的语言障碍。我的职业目标是 建立一个独立的面向患者的研究计划，侧重于设计，实施和 测试信息可视化（INFOVIZ）工具以改善LEP患者的症状通信， 口译员和提供者的目标是最终改善生活质量并减少健康分配。 该K23奖将为我提供（1）Infoviz评估，（2）症状（疼痛）科学，（3）的高级技能 干预研究和（4）专业发展成功地过渡到独立的 研究者。威斯康星大学 - 麦迪逊分校和跨学科的研究环境 指导团队在内，包括博士。克里斯汀·克威克·布姆（Kristine Kwekkeboom）（疼痛和症状管理，干预研究）， Suzanne Bakken（信息可视化评估），Toby Campbell（患者提供沟通）， 罗杰·布朗（Roger Brown）（统计方法）和戴维·拉巴戈（David Rabago）（疼痛，初级保健）提供了特殊的科学 环境和心态。目的是修改和进行量身定制疼痛评估的试验测试 Infoviz工具，以促进患者互动式培训者的疼痛严重程度，位置和质量的交流 在疼痛评估过程中增加相互理解（MU）。 LEP苗族将成为这项研究的重点 因为疼痛对这一组尤其有问题；他们描述了使用视觉隐喻的疼痛 与提供者的知识和口译员不一致，难以准确地翻译隐喻 病人和提供者。这种创新的Infoviz工具将减少三合会的文化和语言障碍 通过（1）消除患者了解医学语言或要求提供者和口译员的需求 分享苗族文化和语言，以及（2）减少解释所需的技能数量。 具体目的是（1）通过参与设计方法评估疼痛评估Infoviz工具45 来自社区的苗族患者（n = 30）和口译员（n = 15）； （2）试行疼痛评估 LEP HMONG患者在初级保健中的Infoviz工具，包括（2A），以检查 实施该工具，（2b）探索三合会的疼痛严重程度，位置和质量的MU的一致性，并且 （2C）评估选定的结果指标，以捕获对沟通，缓解疼痛和疼痛的满意 干扰和探索Infoviz工具概念框架中确定的变量。 AIM 2将使用静态 小组比较设计，在通常的护理下收集20名患者的数据（即使用语言的口译员 疼痛描述），然后在干预条件下从另外20名患者那里收集数据（即 解释者使用言语描述和Infoviz工具）。发现将支持R01效率研究。