Objective

To obtain expert consensus on indicators of quality rehabilitation services for individuals with limited English proficiency (LEP).

Design

Three-round Delphi study.

Setting

Delphi survey conducted online with 30 experts. Most experts worked in adult physical rehabilitation settings and were from Illinois (n=16), and the remaining participants were from 8 other US states or Canadian provinces.

Participants

Experts (N=30) had a minimum of 2 publications on health care services for patients with LEP and/or a minimum of 5 years clinical experience in physical rehabilitation. Of 43 experts (11 researchers, 32 clinicians) who received the round 1 survey by e-mail, 30 returned complete responses (70% response rate). Of those, 25 completed round 2 and 24 completed round 3. Of round 1 participants, most (n =21) identified their primary professional activity as clinical, whereas the others worked in research (n =5) or education (n =4). Twenty-four were women. The median age was 43 years (range, 27-67y). Disciplines included occupational therapy (n =14), physical therapy (n =13), psychology (n=1), nursing (n=1), and medicine (n=1).

Interventions

Not applicable.

Main Outcome Measures

Indicators were rated on a 7-point Likert scale for importance and feasibility. Interquartile range (IQR) and 95% confidence intervals were calculated for importance and feasibility ratings. Indicators with an IQR <2 and a median importance score ≥6 were accepted as reaching consensus for importance.

Results

Round 1 responses were categorized into 15 structural, 13 process, and 18 outcome indicators. All 15 structural indicators reached consensus for importance; 8 were rated as feasible. All 13 process indicators reached consensus, of which 8 were deemed feasible. Sixteen outcome indicators reached consensus, of which 7 were deemed feasible.

Conclusions

This Delphi study identified structural, process, and outcome indicators that can inform delivery and assessment of quality rehabilitation services for individuals with LEP. Future research should operationalize and measure these quality indicators in clinical practice.

中文翻译：

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为英语能力有限的个人提供优质康复服务的指标：3 轮德尔福研究

客观的

为英语能力有限（LEP）的个人获得有关优质康复服务指标的专家共识。

设计

三轮Delphi学习。

环境

德尔福在线调查由 30 位专家参与。大多数专家在成人身体康复机构工作，来自伊利诺伊州 (n=16)，其余参与者来自美国其他 8 个州或加拿大省份。

参与者

专家（N=30）至少发表过 2 篇关于 LEP 患者医疗保健服务的出版物和/或至少 5 年的身体康复临床经验。在通过电子邮件收到第一轮调查的 43 位专家（11 位研究人员、32 位临床医生）中，有 30 位专家回复了完整回复（回复率为 70%）。其中，25 人完成了第二轮，24 人完成了第三轮。 在第一轮参与者中，大多数 (n = 21) 将他们的主要专业活动确定为临床，而其他人则从事研究 (n = 5) 或教育 (n = 4) . 二十四人是女性。中位年龄为 43 岁（范围，27-67 岁）。学科包括职业治疗 (n = 14)、物理治疗 (n = 13)、心理学 (n = 1)、护理 (n = 1) 和医学 (n = 1)。

干预措施

不适用。

主要观察指标

指标的重要性和可行性采用李克特 7 分制评分。计算了重要性和可行性评级的四分位距 (IQR) 和 95% 置信区间。IQR <2 和中位数重要性评分≥6 的指标被接受为重要性达成共识。

结果

第 1 轮响应分为 15 个结构指标、13 个过程指标和 18 个结果指标。15项结构性指标的重要性均达成共识；8个被评为可行。13项工艺指标均达成共识，其中8项被认为可行。16 项成果指标达成共识，其中 7 项被认为是可行的。

结论

Delphi 的这项研究确定了结构、过程和结果指标，可以为 LEP 患者提供和评估优质康复服务提供信息。未来的研究应该在临床实践中操作和衡量这些质量指标。