BACKGROUND Orthopaedic surgery has a diversity gap, as it is not representative of the racial or sex proportions of the U.S. population. This gap can lead to communication barriers stemming from health literacy, language proficiency, or cultural discordance that may contribute to current health inequities. This study assesses the influence of educational attainment, language, and cultural concordance on patient-physician communication. METHODS In this cross-sectional study, 394 patients from an urban orthopaedic clinic were administered a Likert-type survey regarding race or ethnicity, educational level, communication, patient satisfaction, language proficiency, and culture. One-way analysis of variance, chi-square tests, and Welch t tests were used to evaluate responses. RESULTS The majority of subjects identified as African-American/Black (50%) or Hispanic/Latino (30%). Completing high school was associated with a better ability of the subjects to communicate with their orthopaedic surgeon (p < 0.001). Hispanic subjects reported lower English proficiency (p < 0.001) and decreased ability to communicate with their physician (p < 0.001) compared with other subjects, with educational attainment influencing their ability to understand their orthopaedic surgeon in English (p < 0.001). African-American and Hispanic patients placed greater importance on orthopaedic surgeons understanding their culture than White patients (p < 0.001). Hispanic patients who saw a language and culture-concordant surgeon valued having a Spanish-speaking surgeon more than Hispanic patients who did not see a concordant surgeon (p = 0.04). CONCLUSIONS These results suggest that patient-physician language concordance, particularly in patients with lower education, may be essential to delivering high-quality patient care. Hispanic and African-American patients placed significantly greater importance on their orthopaedic surgeons understanding their culture. Hispanic patients frequently sought care with language-concordant surgeons and placed higher value on physicians understanding their culture. To better serve minority communities, efforts should be made to increase orthopaedic surgeons' cultural humility and to recruit a diverse multilingual surgeon workforce. CLINICAL RELEVANCE This research demonstrates that cultural and language concordance, specifically between Hispanic patients and Hispanic, Spanish-speaking surgeons, can significantly enhance patient preference and potentially improve patient satisfaction and outcomes in orthopaedic care. Additionally, it underscores the importance of understanding and addressing the diversity within the field and the patient population to better meet the needs of a multicultural society.

中文翻译：

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教育、语言和文化一致性影响骨科患者与医生的沟通。


背景技术骨科手术存在多样性差距，因为它不能代表美国人口的种族或性别比例。这种差距可能会导致因健康素养、语言熟练程度或文化差异而产生的沟通障碍，从而可能导致当前的健康不平等。本研究评估了教育程度、语言和文化一致性对医患沟通的影响。方法 在这项横断面研究中，对来自城市骨科诊所的 394 名患者进行了有关种族或族裔、教育水平、沟通、患者满意度、语言能力和文化的李克特式调查。使用单因素方差分析、卡方检验和 Welch t 检验来评估响应。结果 大多数受试者被确定为非裔美国人/黑人 (50%) 或西班牙裔/拉丁裔 (30%)。完成高中学业与受试者与骨科医生更好的沟通能力相关（p < 0.001）。与其他受试者相比，西班牙裔受试者的英语水平较低（p < 0.001），与医生沟通的能力也较低（p < 0.001），教育程度影响他们用英语理解骨科医生的能力（p < 0.001）。与白人患者相比，非裔美国人和西班牙裔患者更重视骨科医生了解他们的文化（p < 0.001）。与没有看到语言和文化一致的外科医生的西班牙裔患者相比，看到语言和文化一致的外科医生的西班牙裔患者更看重拥有讲西班牙语的外科医生（p = 0.04）。 结论 这些结果表明，患者与医生的语言一致性，尤其是教育程度较低的患者，对于提供高质量的患者护理可能至关重要。西班牙裔和非裔美国患者更加重视骨科医生了解他们的文化。西班牙裔患者经常向语言一致的外科医生寻求治疗，并且更看重医生了解他们的文化。为了更好地服务少数族裔社区，应努力提高骨科医生的文化谦逊态度，并招募多元化的多语言外科医生队伍。临床相关性 这项研究表明，文化和语言一致性，特别是西班牙裔患者和西班牙裔、讲西班牙语的外科医生之间的文化和语言一致性，可以显着增强患者的偏好，并有可能提高患者对骨科护理的满意度和结果。此外，它强调了理解和解决该领域和患者群体多样性的重要性，以更好地满足多元文化社会的需求。