Telemed J E Health - Transcultural psychiatry made simple--asynchronous telepsychiatry as an approach to providing culturally relevant care.

Tópicos

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Resumo

JECTIVE: To examine the feasibility and diagnostic reliability of asynchronous telepsychiatry (ATP) consultations in Spanish and ATP consultation with Spanish-to-English translation.SUBJECTS AND METHODS: Twenty-four interviews of Spanish-speaking patients were videorecorded by a bilingual clinician who also collected patient history data and gave the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to each patient. The ATP data (video of the interview and patient history) were forwarded for psychiatric consultation and a diagnostic assessment by the investigators. The ATP data were then examined separately by two Spanish-speaking psychiatrists, before being translated into English and then re-examined by two English-speaking psychiatrists. Agreement between the expert diagnoses of the investigators and the diagnoses from the Spanish consultations, the Spanish-to-English translated consultations, and the SCID-I results was assessed using kappa statistics.RESULTS: We found acceptable levels of agreement for major diagnostic groupings among the Spanish- and English-speaking psychiatrists. Kappa values for diagnostic agreement between the expert and the translated consultations, the original language consultations, and the SCID-I were at least 0.52 (percentage agreement, 79%) and higher.CONCLUSIONS: ATP consultations in Spanish, and those translated from Spanish to English, are feasible, and broad diagnostic reliability was achieved. The ATP process allows for rapid language translation. This approach could be useful across national boundaries and in numerous ethnic groups. Cross-language ATP may also offer significant benefits over the use of real-time interpreting services and has the potential to improve the quality of care by allowing for the addition of culturally relevant information.

Resumo Limpo

jectiv examin feasibl diagnost reliabl asynchron telepsychiatri atp consult spanish atp consult spanishtoenglish translationsubject method twentyfour interview spanishspeak patient videorecord bilingu clinician also collect patient histori data gave structur clinic interview dsmiv axi disord scidi patient atp data video interview patient histori forward psychiatr consult diagnost assess investig atp data examin separ two spanishspeak psychiatrist translat english reexamin two englishspeak psychiatrist agreement expert diagnos investig diagnos spanish consult spanishtoenglish translat consult scidi result assess use kappa statisticsresult found accept level agreement major diagnost group among spanish englishspeak psychiatrist kappa valu diagnost agreement expert translat consult origin languag consult scidi least percentag agreement higherconclus atp consult spanish translat spanish english feasibl broad diagnost reliabl achiev atp process allow rapid languag translat approach use across nation boundari numer ethnic group crosslanguag atp may also offer signific benefit use realtim interpret servic potenti improv qualiti care allow addit cultur relev inform

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