Missed Opportunities When Communicating With Limited English-Proficient Patients During End-of-Life Conversations: Insights From Spanish-Speaking and Chinese-Speaking Medical Interpreters

Silva, Milagros D.; Tsai, Stephanie; Sobota, Rosanna M.; Abel, Brittany T.; Reid, M. Carrington; Adelman, Ronald D.

doi:10.1016/j.jpainsymman.2019.10.019

Cited by 26 publications

(72 citation statements)

References 30 publications

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“…57 These barriers are reinforced by clinicians' implicit biases toward and unfamiliarity with Asian cultural nuances during EOL conversations. 58,59 Thus, an examination of the pattern of use and effectiveness of palliative care among Asian Americans may be important in exposing inequities in palliative care access and engagement. Finally, at the policy level, several forces may contribute to the sustained differences in EOL care intensity for Asian Americans.…”

Section: Discussionmentioning

confidence: 99%

Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life

et al. 2021

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“…Medical interpreters often have insight into the background of the child and family with the understanding of the cultural context relevant to the clinical encounter. 12 Rather than serving as an ''invisible party'' or ''neutral translator,'' the interpreter may actually be a ''communication advocate'' within their professional and ethical role. 13 Interpreters are permitted and even encouraged to play in cultural awareness role in medical settings while still remaining neutral and accurately interpreting the medical message.…”

Section: Discussionmentioning

confidence: 99%

Translating Pediatric Hospital Interpreters’ Feedback From Difficult Conversations into Improved Communication

et al. 2020

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Background: Medical interpreters are critical mediators in communication with pediatric subjects and families to include participation in difficult conversations. Objective: The objective of this pilot study was to provide suggestions from medical interpreters to palliative care teams as to how to effectively incorporate medical interpreters into end-of-life conversations. Subjects and Method: Participants included pediatric hospital-based medical interpreters who had interpreted for at least 1 end-of-life conversation in the pediatric hospital setting. A total of 11 surveys were completed by medical interpreters. The study consisted of a written 12-item survey with a follow-up focus group to further explore survey themes. Results: The translation of cultural contexts, awareness of the mixed messages the family received from health care teams, and the emotional intensity of the interactions were depicted as the most challenging aspects of the medical interpreter’s role. Despite these challenges, 9 interpreters reported they would willingly be assigned for interpreting “bad news” conversations if given the opportunity (82%). Medical interpreters recognized their relationship with the family and their helping role for the family as meaningful aspects of interpreting even in difficult conversations. Medical interpreters shared 7 thematic suggestions for improved communication in language-discordant visits: content review, message clarity, advocacy role, cultural understanding, communication dynamics, professionalism, and emotional support. Conclusions: As experts in cultural dynamics and message transmission, the insights of medical interpreters can improve communication with families.

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“…Due to a large number of non‐native English speakers and language‐discordant health care providers, patients, family members, friends or ancillary staff are used without formal training or medical interpreting (Molina & Kasper, 2019 ). Communicating through untrained interpreters may omit physicians' questions, give shortened or biased patient response, and provide an inadequate exchange of information to permit accurate diagnosis and treatment (Silva et al, 2019 ). The larger impact of language barriers on patient comprehension and the associated effects of access to language‐concordant health care providers specifically nurses remain limited.…”

Section: Introductionmentioning

confidence: 99%

Dual‐role nurse interpreter perceptions of language barriers and Spanish‐speaking patients: A qualitative study

Villanueva

2023

Nursing Open

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Aim As the United States population is ever changing and is growing in diverse population patterns, the health care system is called to initiate responsive health care practices that are based on the public's changing and diverse cultural patterns. This study sought to explore the perceptions of certified medical interpreter dual‐role nurses and their experiences with Spanish‐speaking patients from admission to discharge in hospital stays. Design A qualitative descriptive case study was applied in this study. Methods Data was collected from nurses working at a United States Southwest Borderland hospital using purposive sampling and semi‐structured in‐depth interviews. A total of four dual‐role nurses participated, and thematic narrative analysis was applied. Results Four major themes emerged. The main themes were “being a dual‐role nurse interpreter,” “patient experience,” “culture and competence, “and “nursing and caring,” With each major theme multiple sub themes emerged. Two sub themes emerged with “being a dual‐role nurse interpreter,” and two sub themes emerged with “patient experiences.” The major themes that emerged from the interviews indicated that the language barrier greatly affects Spanish‐speaking patients in their hospital stay. Participants reported having at least one encounter with a Spanish‐speaking patient that was not afforded interpretation services or had interpretation from someone other than a qualified interpreter. Patients experienced confusion, apprehension and anger associated with not being able to communicate their needs to the healthcare system. Conclusions According to the experiences of the certified dual‐role nurse interpreters, having a language barrier makes a tremendous impact on the care of Spanish‐speaking patients. Nurse participants describe how patients and their family members experience dissatisfaction, anger and confusion when there is a language barrier and most importantly how language barriers have detrimental effects on patients with wrong medication prescriptions and wrong diagnosis. Clinical relevance When hospital administration recognize and support nurses as certified medical interpreters as a key component for patient care when assisting persons with limited English proficiency, patients are empowered to become active members of their healthcare regimen. The role of dual‐role nurses enables brokering between the healthcare system and serves as a tool to bridge health disparities based on linguistic inequities existing in healthcare. Recruitment and retention of certified medical interpreter trained Spanish‐speaking nurses deter errors in healthcare and makes a positive impact on the healthcare regimen of Spanish‐speaking patients enabling patient empowerment through education and advocacy.

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Missed Opportunities When Communicating With Limited English-Proficient Patients During End-of-Life Conversations: Insights From Spanish-Speaking and Chinese-Speaking Medical Interpreters

Cited by 26 publications

References 30 publications

Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life

Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life

Translating Pediatric Hospital Interpreters’ Feedback From Difficult Conversations into Improved Communication

Dual‐role nurse interpreter perceptions of language barriers and Spanish‐speaking patients: A qualitative study

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